NPIMap

Individual provider Active NPI

Isam Elias Marar, M.D.

  • Internal Medicine Physician
  • Council Bluffs, IA
National Provider Identifier
1104976109
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32105 Issued in IA
Practice address
1701 West Boadway
Council Bluffs, IA 51501
Phone
(712) 256-5600
Fax
(712) 256-3440
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32105 IA Primary

Addresses

Primary practice location

1701 West Boadway
Council Bluffs, IA 51501

Mailing address

1701 West Boadway
Council Bluffs, IA 51501
Phone (712) 256-5600

Other identifiers 1

IdentifierTypeStateIssuer
3160903MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000517 IA Practitioner - Internal MedicinePractitioner - Endocrinology 1658389655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Broadway Clinic, PCGroup PAC ID 2961580667, 2 clinicians

Practice addresses (Care Compare)

1701 W Broadway
Council Bluffs, IA 51501-3822
Phone (712) 256-5600

Hospital & facility affiliations

  • Angels Care Home Health of Iowa Home health agency, Council Bluffs, IA, CCN 167292
  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32105IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Broadway Clinic, PC Internal Medicine CurrentSince Apr 1, 2008 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
All Care Health Center PastSince Dec 19, 2012 Accepting new patients
N a Massih MD PC Internal Medicine Past Accepting new patients
All Care Health Center PastSince Jan 17, 2022 Accepting new patients

Locations

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

1701 W Broadway
Council Bluffs, IA 51501
Phone (712) 256-5600

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/54bd9abd-9cf5-47af-bd4c-c4fcdbd30c2f/
  • FHIR API: https://webprd.ochin.org/prd-fhir/allcarehealthcenter/api/FHIR/R4

Organizations & group practices 5

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

Hospital & facility affiliations 5

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1104976109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WEST BOADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51501",
            "telephone_number": "712-256-5600",
            "fax_number": "712-256-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WEST BOADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51501",
            "telephone_number": "712-256-5600",
            "fax_number": "712-256-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAR",
        "first_name": "ISAM",
        "middle_name": "ELIAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "32105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3160903",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.