Individual provider Active NPI

Ebad Ur Rahman

  • Internal Medicine Physician
  • Huntington, WV
National Provider Identifier
1376995704
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
63883 Issued in TN
Practice address
2900 1St Ave RM 1025
Huntington, WV 25702-1241
Phone
(304) 399-7484
Fax
(304) 399-7579
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29078 WV
Internal Medicine Physician 207R00000X 63883 TN Primary

Addresses

Primary practice location

2900 1St Ave RM 1025
Huntington, WV 25702-1241

Mailing address

39 Emerson Rd
Glen Head, NY 11545-3117

Other practice location 1

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Other practice location 2

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Rahman.Ebad.U.M.D@scs.directstmarys.org St Mary's Hospitalist Services, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, TN, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190806000204 WV Practitioner - Internal Medicine 3870820491 Reassigns benefits to 1 organization
I20210601002209 TN Practitioner - Internal Medicine 3870820491 Reassigns benefits to 1 organization
I20240709001645 OH Practitioner - Internal Medicine 3870820491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6001 E Broad St
Columbus, OH 43213-1502
Phone (614) 234-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29078WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Oct 10, 2024 Accepting new patients
App of Tennessee HM, PLLC CurrentSince May 26, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 21, 2024 Accepting new patients
Signify Health, LLC CurrentSince May 15, 2024 Accepting new patients
W.a. Foote Memorial Hospital Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Interoperability endpoints

  • Direct secure messaging: rahman.ebad.u.m.d@scs.directstmarys.org
  • Direct secure messaging: erahman997249@direct.hfhs.org

Organizations & group practices 5

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 1

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1376995704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 EMERSON RD",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115453117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 1ST AVE RM 1025",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-399-7484",
            "fax_number": "304-399-7579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112131122",
            "country_code": "US",
            "telephone_number": "718-613-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053494",
            "country_code": "US",
            "telephone_number": "304-598-1200",
            "fax_number": "304-598-1699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UR RAHMAN",
        "first_name": "EBAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29078",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "63883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rahman.Ebad.U.M.D@scs.directstmarys.org",
            "affiliation": "Y",
            "affiliationName": "St Mary's Hospitalist Services, LLC",
            "address_1": "2900 1st Ave Rm 1025",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257021241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.