Individual provider Active NPI

Somaya Abboud, MD

  • Internal Medicine Physician
  • West Orange, NJ
National Provider Identifier
1326089004
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA065186 Issued in NJ
Practice address
15 Oak Terrace
West Orange, NJ 07052
Phone
(973) 736-0687
Fax
(973) 325-0427
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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 MA065186 NJ Primary

Addresses

Primary practice location

15 Oak Terrace
West Orange, NJ 07052

Mailing address

15 Oak Terrace
West Orange, NJ 07052
Phone (973) 736-0687

Other identifiers 1

IdentifierTypeStateIssuer
7212003MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040714000291 NJ Practitioner - Internal Medicine 5294714317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson MD GroupGroup PAC ID 6103240478, 110 clinicians

Practice addresses (Care Compare)

1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748
Phone (201) 224-0011

623 Eagle Rock Ave
Suite 1
West Orange, NJ 07052-2948
Phone (973) 736-0687

Hospital & facility affiliations

  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Careone at Livingston Nursing home, Livingston, NJ, CCN 315479

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065186NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson MD Group Internal Medicine CurrentSince Oct 9, 2020 Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 Accepting new patients
The Back Pain Center, LLC Past Accepting new patients
Premier Medical of NJ Past Accepting new patients

Locations

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

784 Grand Ave
Ste 201
Ridgefield, NJ 07657
Phone (201) 346-0999

443 Northfield Ave
West Orange, NJ 07052
Phone (973) 324-0103

401 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 669-5931

623 Eagle Rock Ave
Ste 1
West Orange, NJ 07052
Phone (347) 450-5320

Organizations & group practices 4

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1326089004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OAK TERRACE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-736-0687",
            "fax_number": "973-325-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OAK TERRACE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-736-0687",
            "fax_number": "973-325-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOUD",
        "first_name": "SOMAYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA065186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.