Individual provider Active NPI

Badiaa El-Imad, M.D.

  • Infectious Disease Physician
  • Bridgeport, WV
National Provider Identifier
1174778583
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
24743 Issued in WV
Practice address
527 Medical Park Dr Ste 204
Bridgeport, WV 26330-9009
Phone
(304) 933-3800
Fax
(304) 933-3815
NPI assigned
Nov 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X 24743 WV Primary

Addresses

Primary practice location

527 Medical Park Dr Ste 204
Bridgeport, WV 26330-9009

Mailing address

527 Medical Park Dr Ste 204
Bridgeport, WV 26330-9009
Phone (304) 933-3800

Other identifiers 1

IdentifierTypeStateIssuer
3810023285MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171110000124 NJ Practitioner - Infectious DiseasePractitioner - Internal Medicine 8224294715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Internal MedicineGroup PAC ID 8426958331, 6 clinicians

Practice addresses (Care Compare)

1450 E Chestnut Ave
Suite 3a
Vineland, NJ 08361-8469
Phone (856) 794-8700

Hospital & facility affiliations

  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032
  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Internal Medicine Infectious Disease CurrentSince Sep 11, 2017 Accepting new patients

Locations

155 Bridgeton Pike
Ste A
Mullica Hill, NJ 08062
Phone (856) 223-0500

1450 E Chestnut Ave
Ste 3A
Vineland, NJ 08361
Phone 8567948700 ext. 36

Interoperability endpoints

  • Direct secure messaging: badiaa.elimad@cim.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.7102002

Organizations & group practices 1

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 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": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1174778583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309009",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309009",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-IMAD",
        "first_name": "BADIAA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-26",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WV",
            "license": "24743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023285",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.