Individual provider Active NPI

Ruba Azzam Abdelhadi, MD

  • Pediatric Gastroenterology Physician
  • Kansas City, MO
National Provider Identifier
1184824179
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
2013025648 Issued in MO
Practice address
2401 Gillham Rd
RM 3503.00
Kansas City, MO 64108-4619
Phone
(816) 234-3106
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301077527 MI
Pediatric Gastroenterology Physician 2080P0206X 4301077527 MI
Pediatric Gastroenterology Physician 2080P0206X N7898 TX
Pediatric Gastroenterology Physician 2080P0206X 2013025648 MO Primary
Pediatrics Physician 208000000X 2013025648 MO

Addresses

Primary practice location

2401 Gillham Rd
RM 3503.00
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
RM 3503.00
Kansas City, MO 64108-4619
Phone (816) 234-3106

Other identifiers 2

IdentifierTypeStateIssuer
208259601MedicaidTX
208259602OtherTXCSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20140407001743 KS Practitioner - Pediatric MedicinePractitioner - Gastroenterology 8820156326 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42652TXMDPharmacotherapy Pharmacist
2013025648MOMDPediatrics Physician
4301077527MIMDPediatric Gastroenterology Physician
N7898TXMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Pediatrics CurrentSince Mar 11, 2014 Accepting new patients
Kansas University Physicians Inc CurrentSince Mar 11, 2014 Accepting new patients
Kansas University Physicians Inc Pediatrics Current Accepting new patients
The Children'S Mercy Hospital Past Accepting new patients
The Children'S Mercy Hospital Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

Interoperability endpoints

  • Direct secure messaging: rabdelhadi294704@direct.kuha.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1184824179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "RM 3503.00",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "RM 3503.00",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELHADI",
        "first_name": "RUBA",
        "middle_name": "AZZAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301077527",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301077527",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "N7898",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MO",
            "license": "2013025648",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2013025648",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208259601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "208259602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.