Individual provider Active NPI

Salam H Rajjoub, MD

  • Pulmonary Disease Physician
  • Bridgeport, WV
National Provider Identifier
1366483083
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
20559 Issued in WV
Practice address
700 Genesis Blvd
Bridgeport, WV 26330-9668
Phone
(304) 848-2040
Fax
(304) 848-2042
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 20559 WV Primary

Addresses

Primary practice location

700 Genesis Blvd
Bridgeport, WV 26330-9668

Mailing address

PO Box 6230
Wheeling, WV 26003-0722
Phone (304) 242-7106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100208000163 WV Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7214960319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

700 Genesis Blvd
Bridgeport, WV 26330-9668
Phone (304) 848-2040

Hospital & facility affiliations

  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006
  • St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score
23.43 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.11

Merit-based Incentive Payment System (MIPS)

Final score
88.61 of 100Reported as group
Quality
81.19
Promoting interoperability
100
Improvement activities
40
Cost
76.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20559WVMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Lung Care Inc. Pulmonary Disease CurrentSince Aug 1, 2003 Accepting new patients
Psychiatric Associates Past Accepting new patients

Locations

700 Genesis Blvd
Bridgeport, WV 26330
Phone (304) 808-7000

1160 Johnson Ave
Ste 105
Bridgeport, WV 26330
Phone (304) 842-9084

Organizations & group practices 2

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 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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1366483083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6230",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030722",
            "telephone_number": "304-242-7106",
            "fax_number": "304-242-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GENESIS BLVD",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309668",
            "telephone_number": "304-848-2040",
            "fax_number": "304-848-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJJOUB",
        "first_name": "SALAM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WV",
            "license": "20559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.