Individual provider Active NPI

Omar Elghawanmeh, M.D.

  • Neurology Physician
  • Ashland, KY
National Provider Identifier
1386873073
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
48490 Issued in KY
Practice address
617 23Rd St Ste 400
Ashland, KY 41101-2880
Phone
(606) 408-2820
Fax
(606) 326-0235
NPI assigned
Jul 2, 2009
Last updated
May 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35.137125 OH
Neurology Physician 2084N0400X BP1-0039174 TX
Neurology Physician 2084N0400X 48490 KY Primary

Addresses

Primary practice location

617 23Rd St Ste 400
Ashland, KY 41101-2880

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other practice location 1

2001 Scioto Trl Ste 200
Portsmouth, OH 45662-2845
Phone (740) 353-8100

Other identifiers 2

IdentifierTypeStateIssuer
0173050MedicaidOH
7100423270MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address oelghawanmeh56543@direct.kdhealth.us Direct
Direct Messaging Address oelghawanmeh56543@direct.kdhealth.us Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20160630002362 KY Practitioner - Neurology 0244522738 Reassigns benefits to 1 organization
I20190813003260 OH Practitioner - Neurology 0244522738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kings Daughters Medical Specialties IncGroup PAC ID 6103968029, shared by 2 NPIs, 397 clinicians

Practice addresses (Care Compare)

1901 Argonne Rd
Portsmouth, OH 45662-2827
Phone (740) 353-1978

617 23Rd St
Suite 6
Ashland, KY 41101-2845
Phone (606) 329-1770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP1-0039174TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc Neurology CurrentSince Jul 1, 2016 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jul 1, 2016 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Ashland Hospital Corporation Past Accepting new patients
Kings Daughters Medical Specialties Inc Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

617 23rd St
Ste 400
Ashland, KY 41101
Phone (606) 329-1770

617 23rd St
Ste 6
Ashland, KY 41101
Phone (606) 324-4745

1901 Argonne Rd
Portsmouth, OH 45662
Phone (740) 991-0911

2001 Scioto Trl
Ste 200
Portsmouth, OH 45662
Phone (740) 353-8100

1242 Crescent Dr
Wheelersburg, OH 45694
Phone (740) 574-8441

Interoperability endpoints

  • Direct secure messaging: oelghawanmeh56543@direct.kdhealth.us

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1386873073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 400",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012880",
            "telephone_number": "606-408-2820",
            "fax_number": "606-326-0235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Scioto Trl Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456622845",
            "country_code": "US",
            "telephone_number": "740-353-8100",
            "fax_number": "740-353-8908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELGHAWANMEH",
        "first_name": "OMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35.137125",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "BP1-0039174",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "48490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173050",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100423270",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oelghawanmeh56543@direct.kdhealth.us",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TXT",
            "address_1": "617 23rd St Ste 400",
            "city": "Ashland",
            "state": "KY",
            "country_code": "US",
            "postal_code": "411012880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oelghawanmeh56543@direct.kdhealth.us",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TXT",
            "address_1": "2001 Scioto Trl Ste 200",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456622845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.