Soban Ahmad, MD
Individual provider Active NPI Cardiovascular Disease Physician · Omaha, NE
NPI 1194347138 · NPPES record last updated Jun 28, 2023
Key facts
- NPI
- 1194347138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 9535 (NE)
- Practice address
- 982265 Nebraska Medical Ctr
Omaha, NE 68198-2265 - Phone
- (402) 559-8888
- NPI assigned
- May 13, 2020
- Reactivated
- Feb 24, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern Oregon Cardiology LLC
Practice addresses (Care Compare)
520 Medical Ctr Dr
Suite 200
Medford, OR 97504-4314
Phone (541) 930-7222
Hospital & facility affiliations
- Asante Rogue Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260506003757 | OR | Practitioner - Cardiovascular Disease (Cardiology) | 6507281029 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9535 | NE | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 9535 | NE | Yes |
Addresses
Primary practice location
982265 Nebraska Medical Ctr
Omaha, NE 68198-2265
Mailing address
982265 Nebraska Medical Ctr
Omaha, NE 68198-2265
Phone (402) 559-8888
Other providers in Omaha, NE
- Koffi Wolali Ahlijah
- Aheba Delali Ahlin
- Hailey Elizabeth Ahlman
- Kelsey Ahlschwede
- Faran Ahmad
- Abigail Leigh Ahmann
- Lisa Ahmann
- Taylor Ahmed-Baker
- Abdi Mohamed Ahmed
- Anas Ashfaq Ahmed
All providers in Omaha, NE · Cardiovascular Disease Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.