Individual provider Active NPI

Eyad Khabbaz, M.D.

  • Specialist
  • Punxsutawney, PA
National Provider Identifier
1417113085
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
81 Hillcrest Dr
BP-4109
Punxsutawney, PA 15767-2605
Phone
(814) 938-4910
Fax
(814) 938-5461
NPI assigned
Aug 4, 2008
Last updated
Sep 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary
Otolaryngology Physician 207Y00000X 004294 GA

Addresses

Primary practice location

81 Hillcrest Dr
BP-4109
Punxsutawney, PA 15767-2605

Mailing address

81 Hillcrest Dr
Suite 2600
Punxsutawney, PA 15767-2605
Phone (814) 938-4910

Other identifiers 2

IdentifierTypeStateIssuer
311170846OtherUNIVERSITY EAR NOSE AND THROAT SPECIALISTS
207Y00000XMedicaidGA

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
I20240802003826 WV Practitioner - Otolaryngology 0840429411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1020WVMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jul 23, 2024 Accepting new patients
West Virginia University Medical Corporation Otolaryngology CurrentSince Jul 23, 2024 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

600 Suncrest Town Centre Dr
Morgantown, WV 26505
Phone (304) 598-4279

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, 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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1417113085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "address_2": "SUITE 2600",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-4910",
            "fax_number": "814-938-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "address_2": "BP-4109",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-4910",
            "fax_number": "814-938-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHABBAZ",
        "first_name": "EYAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "004294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY EAR NOSE AND THROAT SPECIALISTS",
            "identifier": "311170846",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207Y00000X",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Punxsutawney, PA

Sources for this page

Verify at the official NPI Registry.