NPIMap

Individual provider Active NPI

Haitham Nsour, MD

  • Pulmonary Disease Physician
  • Middletown, NY
National Provider Identifier
1306833959
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
246296 Issued in NY
Practice address
155 Crystal Run Rd
Middletown, NY 10941-4028
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Sep 29, 2005
Last updated
Nov 18, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 246296 NY
Pulmonary Disease Physician 207RP1001X 246296 NY Primary

Addresses

Primary practice location

155 Crystal Run Rd
Middletown, NY 10941-4028

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
02635472MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20120503000676 VT Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 6002861622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center IncGroup PAC ID 5496714313, 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-8852

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246296NYMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Jul 2, 2018 Accepting new patients
Central Vermont Medical Center Inc CurrentSince May 1, 2016 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Jul 2, 2018 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Mar 7, 2012 Accepting new patients
Central Vermont Medical Center Inc CurrentSince May 1, 2016 Accepting new patients
Pulmonary Critical Care Inc Pulmonary Disease Past Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

Interoperability endpoints

  • Direct secure messaging: haitham.nsour@nmc.medalliesdirect.net

Organizations & group practices 7

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 3

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1306833959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSOUR",
        "first_name": "HAITHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "246296",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "246296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02635472",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.