NPIMap

Individual provider Active NPI

Ahmad Issam Mahmoud Abualsoud, MBBCH

  • Otolaryngology Physician
  • Bethlehem, PA
National Provider Identifier
1235611005
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD473596 Issued in PA
Practice address
3445 High Point Blvd Ste 400
Bethlehem, PA 18017-7817
Phone
(610) 866-5555
Fax
(610) 866-3151
NPI assigned
Aug 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD PA
Pediatric Otolaryngology Physician 207YP0228X MD473596 PA
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X MD473596 PA Primary

Addresses

Primary practice location

3445 High Point Blvd Ste 400
Bethlehem, PA 18017-7817

Mailing address

3445 High Point Blvd Ste 400
Bethlehem, PA 18017-7817
Phone (610) 866-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210512002216 PA Practitioner - Otolaryngology 1456760982 Reassigns benefits to 3 organizations
I20211124001716 NJ Practitioner - Otolaryngology 1456760982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Physician Associates, LLCGroup PAC ID 6204012016, 43 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

3445 High Point Blvd
Suite 400
Bethlehem, PA 18017-7817
Phone (610) 866-5555

3445 Highpointe Blvd
Bethlehem, PA 18017-7817
Phone (610) 776-4512

497 Bushkill Plaza LN
Wind Gap, PA 18091-9602
Phone (610) 776-4512

6689 Sullivan TRL
Wind Gap, PA 18091-9790
Phone (610) 954-4960

6695 Sullivan TRL
Suite 201
Wind Gap, PA 18091-9790
Phone (610) 691-3131

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Warren Hospital Hospital, Phillipsburg, NJ, CCN 310060
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD473596PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Star Community Health, Inc Multi-Specialty CurrentSince Feb 4, 2022 Accepting new patients
Specialty Physician Associates, LLC Multi-Specialty CurrentSince Jun 1, 2021 Accepting new patients
St. Luke'S Warren Physician Group, PC Multi-Specialty CurrentSince Oct 1, 2021 Accepting new patients
St. Luke'S Warren Physician Group, PC Multi-Specialty Current Accepting new patients
St. Luke'S Warren Physician Group, PC Multi-Specialty CurrentSince Oct 1, 2021 Accepting new patients
Star Community Health, Inc Otolaryngology CurrentSince Feb 4, 2022 Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

450 Chew St
#101
Allentown, PA 18102
Phone (610) 776-4888

511 E 3rd St
Ste 301
Bethlehem, PA 18015
Phone (484) 526-2460

3445 High Point Blvd
Ste 400
Bethlehem, PA 18017
Phone (610) 824-5050

511 E 3rd St
Ste 200
Bethlehem, PA 18015
Phone (484) 526-4700

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/76651

Organizations & group practices 7

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 9

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1235611005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 HIGH POINT BLVD STE 400",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177817",
            "telephone_number": "610-866-5555",
            "fax_number": "610-866-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 HIGH POINT BLVD STE 400",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177817",
            "telephone_number": "610-866-5555",
            "fax_number": "610-866-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUALSOUD",
        "first_name": "AHMAD",
        "middle_name": "ISSAM MAHMOUD",
        "name_prefix": "Dr.",
        "credential": "MBBCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "PA",
            "license": "MD473596",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD473596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.