NPIMap

Individual provider Active NPI

Mohamad Ali Azzam, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Webster, TX
National Provider Identifier
1144517467
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
Q7634 Issued in TX
Practice address
220 E Medical Center Blvd
Webster, TX 77598-4319
Phone
(832) 930-9001
Fax
(281) 672-7162
NPI assigned
Jul 7, 2011
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 4301106733 MI
Interventional Pain Medicine Physician 208VP0014X Q7634 TX
Pain Medicine (Anesthesiology) Physician 207LP2900X Q7634 TX Primary

Addresses

Primary practice location

220 E Medical Center Blvd
Webster, TX 77598-4319

Mailing address

PO Box 58383
Webster, TX 77598-8383
Phone (832) 930-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160914001807 TX Practitioner - Anesthesiology 5991015158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northeastern Ohio University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Pain Management PLLCGroup PAC ID 2062789480, 6 clinicians

Practice addresses (Care Compare)

220 E Medical Ctr Blvd
Webster, TX 77598-4319
Phone (832) 930-9001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.27 of 100Reported as group
Quality
100
Improvement activities
40
Cost
80.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q7634TXMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management PLLC Pain Medicine CurrentSince Jun 1, 2017 Accepting new patients
Polaris Anesthesia PLLC PastSince Sep 1, 2020 Accepting new patients

Locations

220 E Medical Center Blvd
Webster, TX 77598
Phone (832) 858-6531

600 N Kobayashi
Ste 311
Webster, TX 77598
Phone (281) 724-4711

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23637/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCCHBD/Endpoint/DCCHBD

Organizations & group practices 3

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 11

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1144517467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58383",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775988383",
            "telephone_number": "832-930-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984319",
            "telephone_number": "832-930-9001",
            "fax_number": "281-672-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZAM",
        "first_name": "MOHAMAD",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301106733",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "Q7634",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "Q7634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.