NPIMap

Individual provider Active NPI

Addi S Abuelshar, MD

  • Internal Medicine Physician
  • Altus, OK
National Provider Identifier
1295721678
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20057 Issued in OK
Practice address
1200 E Pecan
JCMH/ Hospitalist Office
Altus, OK 73521
Phone
(580) 379-5992
Fax
(580) 379-5999
NPI assigned
Sep 21, 2005
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 20057 OK Primary

Addresses

Primary practice location

1200 E Pecan
JCMH/ Hospitalist Office
Altus, OK 73521

Mailing address

1200 E Pecan
JCMH/ Hospitalist Office
Altus, OK 73521
Phone (580) 379-5992

Other identifiers 1

IdentifierTypeStateIssuer
10225280AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AddiAbuelshar@direct.jcmh.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20070615000522 OK Practitioner - Internal Medicine 6800995846 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson County Memorial Hospital AuthorityGroup PAC ID 1759293178, shared by 9 NPIs, 46 clinicians

Practice addresses (Care Compare)

205 S Park LN
Suite 210
Altus, OK 73521-5757
Phone (580) 379-6650

400 E Chestnut St
Hollis, OK 73550-2030
Phone (580) 688-3363

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20057OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Current Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Grady Memorial Hospital CurrentSince Feb 1, 2023 Accepting new patients
Nemri Medical Services, Inc. Past Accepting new patients
Jackson County Memorial Hosp Phcy Past Accepting new patients
Amarillo Hospitalist PA Internal Medicine Past Accepting new patients

Locations

2100 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

Interoperability endpoints

  • Direct secure messaging: addiabuelshar@direct.jcmh.com
  • Direct secure messaging: him@direct.jcmh.com

Organizations & group practices 8

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1295721678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN",
            "address_2": "JCMH/ HOSPITALIST OFFICE",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "73521",
            "telephone_number": "580-379-5992",
            "fax_number": "580-379-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN",
            "address_2": "JCMH/ HOSPITALIST OFFICE",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "73521",
            "telephone_number": "580-379-5992",
            "fax_number": "580-379-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUELSHAR",
        "first_name": "ADDI",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "20057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10225280A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AddiAbuelshar@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "1200 E Pecan",
            "address_2": "JCMH/ HOSPITALIST OFFICE",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "73521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.