Individual provider Active NPI

Syed Ali Abbas, MD

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1205458247
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
58245 Issued in KY
Practice address
401 E Chestnut St Unit 600
Louisville, KY 40202-5705
Phone
(502) 588-4865
NPI assigned
May 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X TP479 KY
Psychiatry Physician 2084P0800X R5411 KY
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 58245 KY Primary

Addresses

Primary practice location

401 E Chestnut St Unit 600
Louisville, KY 40202-5705

Mailing address

5514 Antle Dr
Louisville, KY 40229-2955
Phone (716) 930-3412

Other practice location 1

2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570
Phone (270) 417-7980

Other practice location 2

908 Wallace Ave Ste 201
Leitchfield, KY 42754-1495
Phone (270) 230-0212

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sabbas121194@direct.owensborohealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220706002200 KY Practitioner - Psychiatry 8123408341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Owensboro Health Medical Group IncGroup PAC ID 0648255034, 455 clinicians

Practice addresses (Care Compare)

2211 Mayfair Dr
Suite 409
Owensboro, KY 42301-4570
Phone (270) 417-7980

Hospital & facility affiliations

  • Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58245KYMDPsychiatry Physician
R5411KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Apr 28, 2023 Accepting new patients
Owensboro Health Medical Group, Inc Psychiatry CurrentSince Apr 28, 2023 Accepting new patients

Locations

908 Wallace Ave
Ste 201
Leitchfield, KY 42754
Phone (270) 230-0212

401 E Chestnut St
Unit 600
Louisville, KY 40202
Phone (502) 588-4425

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

2211 Mayfair Dr
Ste 409
Owensboro, KY 42301
Phone (270) 417-7980

Organizations & group practices 4

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 1

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": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1205458247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5514 ANTLE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292955",
            "telephone_number": "716-930-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 600",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025705",
            "telephone_number": "502-588-4865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Mayfair Dr Ste 409",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423014570",
            "country_code": "US",
            "telephone_number": "270-417-7980",
            "fax_number": "270-417-7989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "908 Wallace Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Leitchfield",
            "state": "KY",
            "postal_code": "427541495",
            "country_code": "US",
            "telephone_number": "270-230-0212",
            "fax_number": "270-230-0104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABBAS",
        "first_name": "SYED",
        "middle_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-13",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "TP479",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "R5411",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "58245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sabbas121194@direct.owensborohealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sabbas121194@direct.owensborohealth.org",
            "address_1": "2211 Mayfair Dr Ste 409",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423014570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.