Individual provider Active NPI

Fadi E Damouni, MD

  • Internal Medicine Physician
  • Millsboro, DE
National Provider Identifier
1245295260
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C10005379 Issued in DE
Practice address
26744 John J Williams Hwy.
Suite #7
Millsboro, DE 19966
Phone
(302) 945-0440
Fax
(302) 945-0442
NPI assigned
Apr 20, 2006
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C10005379 DE Primary

Addresses

Primary practice location

26744 John J Williams Hwy.
Suite #7
Millsboro, DE 19966

Mailing address

26744 John J Williams Hwy
Suite 7
Millsboro, DE 19966-4667
Phone (302) 945-0440

Other identifiers 1

IdentifierTypeStateIssuer
0000874601MedicaidDE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fadi.damouni@phl.eclinicaldirectplus.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20060307000570 DE Practitioner - Internal Medicine 7719994342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peninsula Health LLCGroup PAC ID 7416019765, 2 clinicians

Practice addresses (Care Compare)

26744 John J Williams Hwy
Unit 3
Millsboro, DE 19966-4667
Phone (302) 945-0440

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10005379DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Health LLC Internal Medicine CurrentSince Dec 1, 2008 Accepting new patients

Locations

26744 John J Williams Hwy
Unit 3
Millsboro, DE 19966
Phone (302) 945-0440

26744 John J Williams Hwy
Unit 7
Millsboro, DE 19966
Phone (302) 536-5215

Interoperability endpoints

  • Direct secure messaging: fadi.damouni@phl.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHBEBA/Endpoint/IHBEBA

Organizations & group practices 1

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 10

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1245295260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26744 JOHN J WILLIAMS HWY",
            "address_2": "SUITE 7",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199664667",
            "telephone_number": "302-945-0440",
            "fax_number": "302-945-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26744 JOHN J WILLIAMS HWY.",
            "address_2": "SUITE #7",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "19966",
            "telephone_number": "302-945-0440",
            "fax_number": "302-945-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMOUNI",
        "first_name": "FADI",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10005379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000874601",
            "state": "DE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fadi.damouni@phl.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "eclinicalworks is the ehr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "26744 John J Williams Hwy.",
            "address_2": "Suite #7",
            "city": "Millsboro",
            "state": "DE",
            "country_code": "US",
            "postal_code": "19966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Millsboro, DE

Sources for this page

Verify at the official NPI Registry.