Individual provider Active NPI

Mohammad Khalouck Abdrabbo, MD

  • Gastroenterology Physician
  • Montgomery, OH
National Provider Identifier
1104828201
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35.143765 Issued in OH
Practice address
10600 Montgomery Rd
Montgomery, OH 45242-4463
Phone
(513) 853-9250
NPI assigned
Aug 10, 2005
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 4301055436 MI
Gastroenterology Physician 207RG0100X 35.143765 OH Primary

Addresses

Primary practice location

10600 Montgomery Rd
Montgomery, OH 45242-4463

Mailing address

10600 Montgomery Rd
Montgomery, OH 45242-4463
Phone (513) 853-9250

Other practice location 1

1675 Leahy St
Suie 324B
Muskegon, MI 49442-5500
Phone (231) 726-5075

Other practice location 2

2116 Craig Rd
Eau Claire, WI 54701-6149
Phone (715) 848-4965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080724000386 WI Practitioner - Gastroenterology 9032145644 Reassigns benefits to 3 organizations
I20220406002854 OH Practitioner - Gastroenterology 9032145644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 246-2400

10506 A Montgomery Rd
Montgomery, OH 45242-4402

10600 Montgomery Rd
Suite 300
Montgomery, OH 45242-4464
Phone (513) 853-9250

375 Dixmyth Ave
Cincinnati, OH 45220-2475

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 246-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy110
Upper gastrointestinal (GI) endoscopy for acid reflux70

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301055436MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jan 15, 2019 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jan 15, 2019 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Mar 5, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 5, 2019 Accepting new patients
Trihealth H LLC Gastroenterology CurrentSince Apr 11, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 6, 2014 Accepting new patients
HPCN Past Accepting new patients
HPCN Gastroenterology Past Accepting new patients
HPCN Past Accepting new patients
HPCN Past Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

10600 Montgomery Rd
Montgomery, OH 45242
Phone (513) 236-2697

10600 Montgomery Rd
Ste 300
Montgomery, OH 45242
Phone (513) 794-2600

8040 Princeton Glendale Rd
West Chester, OH 45069
Phone (513) 346-5065

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1020 Lakeshore Dr
Rice Lake, WI 54868
Phone (715) 236-8100

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: mabdrabbo355646@direct.trihealth.com
  • Direct secure messaging: mohammad.abdrabbo@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1104828201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424463",
            "telephone_number": "513-853-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424463",
            "telephone_number": "513-853-9250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Leahy St",
            "address_2": "SUIE 324B",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494425500",
            "country_code": "US",
            "telephone_number": "231-726-5075",
            "fax_number": "231-728-1685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016149",
            "country_code": "US",
            "telephone_number": "715-848-4965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDRABBO",
        "first_name": "MOHAMMAD",
        "middle_name": "KHALOUCK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301055436",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.143765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.