Individual provider Active NPI

Ahmad Dabbouseh, DPM

  • Foot & Ankle Surgery Podiatrist
  • Munster, IN
National Provider Identifier
1235768078
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07001415A Issued in IN
Practice address
9900 Columbia Ave
Munster, IN 46321-4008
Phone
(219) 924-3300
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 07001415A IN Primary

Addresses

Primary practice location

9900 Columbia Ave
Munster, IN 46321-4008

Mailing address

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606001334 IN Practitioner - Podiatry 3173980208 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians
Orthopaedic Specialists of Northwest Indiana PCGroup PAC ID 5092788901, 18 clinicians

Practice addresses (Care Compare)

4320 Fir St
Unit 201
East Chicago, IN 46312-3076
Phone (219) 392-7664

730 45TH St
Munster, IN 46321-2818
Phone 2199243300150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue360
Removal of skin lesions1-10
Removal of nail tissue211
Removal or shaving of skin growth100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of Northwest Indiana PC CurrentSince Jul 24, 2023 Accepting new patients
Community Care Network Inc CurrentSince Jul 24, 2023 Accepting new patients

Locations

4320 Fir St
Unit 201
East Chicago, IN 46312
Phone (219) 392-7664

4321 Fir St
Ste 313
East Chicago, IN 46312
Phone (219) 392-7424

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

730 45th St
Munster, IN 46321
Phone (219) 922-3016

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9900 Columbia Ave
Munster, IN 46321
Phone (219) 924-3300

10240 Calumet Ave
Munster, IN 46321
Phone (219) 703-2420

9200 Calumet Ave
Ste S200
Munster, IN 46321
Phone (219) 961-9621

10200 Wicker Ave
Saint John, IN 46373
Phone (219) 365-0970

10200 Wicker Ave
#1
Saint John, IN 46373
Phone (219) 365-6728

Interoperability endpoints

  • Direct secure messaging: adabbouseh@osnwi1911.srs-direct.com
  • Direct secure messaging: adabbouseh148419@ssdirect.comhs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1235768078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214008",
            "telephone_number": "219-924-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABBOUSEH",
        "first_name": "AHMAD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001415A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.