Omar Abousoud, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD465946 Issued in PA

Practice address

255 W Lancaster Ave
Paoli, PA 19301-1763

Phone

(484) 565-1074

NPI assigned

Apr 29, 2011

Last updated

Aug 23, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Diagnostic RadiologyAlso: Interventional Radiology

Education

Wright State University Boonshoft School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians

Main Line Health Imaging LPGroup PAC ID 7618867664, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Main Line Health Imaging LP

  • Diagnostic Radiology Physician
  • Wynnewood, PA
  • NPI 1477504264
  Medicare reassignment Care Compare group NPD
• Radiology Associates of the Main Line P C

  • Diagnostic Radiology Physician
  • Paoli, PA
  • NPI 1750332003
  Medicare reassignment Care Compare group NPD
• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  NPD (past)

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

• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Paoli Hospital

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Bryn Mawr Hospital

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  dba Hospital of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1457642019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678678",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678678",
            "telephone_number": "800-475-6112",
            "fax_number": "423-826-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOUSOUD",
        "first_name": "OMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-29",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD465946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 600 Paoli Point Drive Opco, LLC
• 600 Paoli Pointe Drive Operations LLC (Highgate at Paoli Pointe)
• A Guided Heart Home Care LLC
• Acme Markets Inc (Acme Pharmacy #0192)
• Cheryl Acosta-Kiesel, MS
• Susan Parish Adamiak, MBA, MA, LPC
• Kristie M Adamo, RN, CRNA, MSN
• Philip A Adelman, MD

• Diagnostic Radiology Physician in Paoli, PA
• Providers in Paoli, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.