Organization Active NPI

Michael Abboud OBGYN PC

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1316260375
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
232699 Issued in NY
Legal business name
MICHAEL ABBOUD OBGYN PC
Practice address
1009 Brighton Beach Ave
3Rd Floor
Brooklyn, NY 11235-5621
Phone
(718) 743-3183
NPI assigned
Mar 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Authorized official

Name
Aiman Michael Abboud, M.D., D.ONPI 1063511970
Title
Sole Proprietor
Phone
(718) 743-3183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 232699 NY Primary

Addresses

Primary practice location

1009 Brighton Beach Ave
3Rd Floor
Brooklyn, NY 11235-5621

Mailing address

1009 Brighton Beach Ave
3Rd Floor
Brooklyn, NY 11235-5621
Phone (718) 743-3183

Other identifiers 1

IdentifierTypeStateIssuer
02634128MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100415000726 NY Part B Supplier - Clinic/Group Practice 5890822282 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1009 Brighton Beach Ave
Ste 3
Brooklyn, NY 11235
Phone (718) 743-3121

235 Dongan Hills Ave
Staten Island, NY 10305
Phone (718) 351-7650

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1316260375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 BRIGHTON BEACH AVE",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355621",
            "telephone_number": "718-743-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 BRIGHTON BEACH AVE",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355621",
            "telephone_number": "718-743-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL ABBOUD OBGYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "ABBOUD",
        "authorized_official_first_name": "AIMAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "718-743-3183",
        "authorized_official_credential": "M.D., D.O"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "232699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02634128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.