NPIMap

Individual provider Active NPI

Charles F Bou-Abboud, MD

  • Gastroenterology Physician
  • Beckley, WV
National Provider Identifier
1255324844
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
16314 Issued in WV
Practice address
58 Brookshire Lane
Beckley, WV 25801-6765
Phone
(304) 252-4900
Fax
(304) 252-8470
NPI assigned
Aug 30, 2005
Last updated
Mar 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 16314 WV Primary

Addresses

Primary practice location

58 Brookshire Lane
Beckley, WV 25801-6765

Mailing address

58 Brookshire Lane
Beckley, WV 25801-6765
Phone (304) 252-4900

Other identifiers 1

IdentifierTypeStateIssuer
6001170000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071114000448 WV Practitioner - GastroenterologyPractitioner - Hematology 2961590518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Hematology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

58 Brookshire LN
Beckley, WV 25801-6765
Phone (304) 252-4900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80 of 100Reported as individual
Quality
60
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy540
Upper gastrointestinal (GI) endoscopy for acid reflux598

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charles F Bou-Abboud MD PLLC CurrentSince Aug 5, 2000 Accepting new patients

Locations

58 Brookshire Ln
Beckley, WV 25801
Phone (304) 252-4900

Interoperability endpoints

  • Direct secure messaging: charles.bou-abboud@wvafn.hcadirect.net
  • Direct secure messaging: charlesbouabboud@arh.medalliesdirect.net

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1255324844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BROOKSHIRE LANE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016765",
            "telephone_number": "304-252-4900",
            "fax_number": "304-252-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BROOKSHIRE LANE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016765",
            "telephone_number": "304-252-4900",
            "fax_number": "304-252-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOU-ABBOUD",
        "first_name": "CHARLES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "16314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001170000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.