Abdelkader Mallouk, MD, OD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

277295 Issued in NY

Practice address

100 John Roemmelt Dr Ste 302
Horseheads, NY 14845-8304

Phone

(607) 873-1810

Fax

(607) 562-3157

NPI assigned

Oct 2, 2006

Last updated

Apr 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Family PracticeAlso: Addiction Medicine, Optometry

Education

New England College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Corning, NY, CCN 337292
• Carefirst / Southern Tier Hospice and Palliative Hospice, Painted Post, NY, CCN 331513
• Arnot Ogden Medical Center Hospital, Elmira, NY, CCN 330090

Merit-based Incentive Payment System (MIPS)

Final score

81.64 of 100Reported as group

Quality

55.31

Promoting interoperability

99

Improvement activities

40

Cost

76.8

Merit-based Incentive Payment System (MIPS)

Final score

80.15 of 100Reported as group

Quality

46.76

Promoting interoperability

100

Improvement activities

40

Cost

77.08

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abdelkader.mallouk@arn.eclinicaldirectplus.com
• Direct secure messaging: amallouk20860@direct.xtensys.com

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.

• Arnot Ogden Medical Center

  • General Acute Care Hospital
  • Elmira, NY
  • NPI 1083605661
  Medicare reassignment Care Compare group NPD
• Arnot Medical Services PLLC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1427326768

  Family Medicine

  Medicare reassignment NPD
• Suboxonet Medical Group LLC

  • Addiction Medicine (Family Medicine) Physician
  • New Orleans, LA
  • NPI 1851165625

  NY

  Medicare reassignment
• Arnot Ogden Medical Center

  • Community/Retail Pharmacy
  • Elmira, NY
  • NPI 1831875004
  NPD
• Dick Van Dyke Addiction Treatment Center

  • Community/Behavioral Health Agency
  • Ovid, NY
  • NPI 1730274937
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arnot Ogden Medical Center

  • General Acute Care Hospital
  • Elmira, NY
  • NPI 1083605661
  Care Compare affiliation
• Carefirst Ny, Inc.

  dba Southern Tier Hospice and Palliative Care (formerly)

  • Community Based Hospice Care Agency
  • Painted Post, NY
  • NPI 1285638775
  Care Compare affiliation
• QC-Medi New York, Inc.

  dba CenterWell Home Health

  • Home Health Agency
  • Corning, NY
  • NPI 1114959988
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1407949621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JOHN ROEMMELT DR STE 302",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458304",
            "telephone_number": "607-873-1810",
            "fax_number": "607-562-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOUK",
        "first_name": "ABDELKADER",
        "name_prefix": "Mr.",
        "credential": "MD, OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3141",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T005983",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE8142",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "277295",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "277295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01916898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lois Love, RN
• Julie A Luckman
• Barbara A Macblane, RPH
• Kathleen A Machuga, NP
• Kristy Makasziw
• Christopher Malvica, PTA, DPT
• Marc T Riley, PT, PC (Elite Therapy NY)
• Cori Allyn Martino, PHARMD
• Jaclyn Marie Mascho, PT
• Norma Jean Mattocks, NP

• Family Medicine Physician in Horseheads, NY
• Providers in Horseheads, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.