Advanced Heart Care

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

036097388 Issued in IL

Legal business name

ADVANCED HEART CARE

Practice address

4600 Memorial Dr
W3
Belleville, IL 62226-5366

Phone

(618) 222-8900

Fax

(618) 222-8950

NPI assigned

Sep 17, 2008

Last updated

Jan 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Omar Almousalli, MDNPI 1134161904

Title

Owner

Phone

(618) 222-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12464/brand/1/csg/1/fhir/r4

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Omar Almousalli, M.D.

  • Cardiovascular Disease Physician
  • Festus, MO
  • NPI 1134161904

  IL

  Medicare reassignment Authorized official
• John J Lehman Jr., MD

  • Cardiovascular Disease Physician
  • Belleville, IL
  • NPI 1568480374
  Medicare reassignment
• Mohammad Nour Zabad

  • Cardiovascular Disease Physician
  • Bridgeton, MO
  • NPI 1609109883

  IL

  Medicare reassignment
• Danielle Renae Blake

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1295353308
  NPD
• Lindsey Michelle Senci, FNP-C

  • Clinical Nurse Specialist
  • Belleville, IL
  • NPI 1649771544
  NPD (past)
• Stephanie K Fraser, PA-C

  • Medical Physician Assistant
  • Tacoma, WA
  • NPI 1598090656
  NPD (past)
• Enas Rashid Yassin, MD,BSN, NP-C

  • Nurse Practitioner
  • Burlingame, CA
  • NPI 1245597640
  NPD (past)

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1356590178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23140",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622230140",
            "telephone_number": "618-222-8900",
            "fax_number": "618-222-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR",
            "address_2": "W3",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265366",
            "telephone_number": "618-222-8900",
            "fax_number": "618-222-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEART CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "ALMOUSALLI",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-222-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036097388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360973885",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Belleville, IL
• Providers in Belleville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.