Individual provider Active NPI

Abdallah Khaldoun Said Qtaishat, M.D.

  • Internal Medicine Physician
  • Washington D.C., DC
National Provider Identifier
1245979152
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-51316 Issued in KS
Practice address
110 Irving St. NW
Department of Internal Medicine
Washington D.C., DC 20010
Phone
(202) 877-2835
Fax
(202) 877-8288
NPI assigned
May 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 04-51316 KS Primary

Addresses

Primary practice location

110 Irving St. NW
Department of Internal Medicine
Washington D.C., DC 20010

Mailing address

110 Irving St. NW
Department of Internal Medicine
Washington D.C., DC 20010
Phone (202) 877-2835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20250821002079 KS Practitioner - Internal Medicine 6608376975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

929 N Saint Francis Ave
HMP of TX PLLC
Wichita, KS 67214-3821
Phone (316) 291-4396

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122
  • Via Christi Hospital Wichita St Teresa, Inc Hospital, Wichita, KS, CCN 170200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-51316KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jun 27, 2025 Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients

Locations

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

14800 W Saint Teresa St
Wichita, KS 67235
Phone (316) 268-6976

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 2

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 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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1245979152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 IRVING ST. NW",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "WASHINGTON D.C.",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-877-2835",
            "fax_number": "202-877-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST. NW",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "WASHINGTON D.C.",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-877-2835",
            "fax_number": "202-877-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QTAISHAT",
        "first_name": "ABDALLAH",
        "middle_name": "KHALDOUN SAID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-51316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington D.C., DC

Sources for this page

Verify at the official NPI Registry.