NPIMap

Individual provider Active NPI

Chadi Elias Bou Serhal, M.D., M.S.

  • Critical Care Medicine (Internal Medicine) Physician
  • Canton, OH
National Provider Identifier
1124163613
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
35-086682 Issued in OH
Practice address
2600 Tuscarawas St W
Suite 100
Canton, OH 44708-4644
Phone
(330) 452-8844
Fax
(330) 452-7012
NPI assigned
Feb 21, 2007
Last updated
Jan 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.086682 OH
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35-086682 OH Primary
Pulmonary Disease Physician 207RP1001X 35-086682 OH
Sleep Medicine (Internal Medicine) Physician 207RS0012X 35-086682 OH

Addresses

Primary practice location

2600 Tuscarawas St W
Suite 100
Canton, OH 44708-4644

Mailing address

2600 Tuscarawas St W
Suite 100
Canton, OH 44708-4644
Phone (330) 452-8844

Other identifiers 2

IdentifierTypeStateIssuer
2750321MedicaidOH
35.086682OtherOHOHIO LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070827000433 OH Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 4385736099 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease, Sleep Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aultman HospitalGroup PAC ID 3779485867, 41 clinicians
Pulmonary Physicians IncGroup PAC ID 2264429117, 11 clinicians

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 452-9911

2600 Tuscarawas St W
Suite 100
Canton, OH 44708-4696
Phone (330) 452-8844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.98 of 100Reported as individual
Quality
80
Promoting interoperability
100
Improvement activities
40
Cost
59.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-086682OHMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Hospital CurrentSince May 1, 2023 Accepting new patients
Aultman Hospital CurrentSince May 1, 2023 Accepting new patients
Orrville Hospital Foundation CurrentSince May 1, 2023 Accepting new patients
Orrville Hospital Foundation CurrentSince May 1, 2023 Accepting new patients
Akron Children's Hospital Current Accepting new patients
Select Specialty Hospital - Northeast Ohio Inc Past Accepting new patients
Aultman Hospital Past Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 Tuscarawas St W
Ste 100
Canton, OH 44708
Phone (330) 452-8844

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

Interoperability endpoints

  • Direct secure messaging: cbouserhal118573@direct.chmca.org
  • Direct secure messaging: chadibouserhal@ppoh.allscriptsdirect.net

Organizations & group practices 8

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 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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1124163613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084644",
            "telephone_number": "330-452-8844",
            "fax_number": "330-452-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084644",
            "telephone_number": "330-452-8844",
            "fax_number": "330-452-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOU SERHAL",
        "first_name": "CHADI",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.086682",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35-086682",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35-086682",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OH",
            "license": "35-086682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2750321",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE NUMBER",
            "identifier": "35.086682",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.