NPIMap

Individual provider Active NPI

Housam I Haddad, M.D.

  • Internal Medicine Physician
  • Liberty, KY
National Provider Identifier
1467422253
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31531 Issued in KY
Practice address
187 Wolford Ave
Liberty, KY 42539-3187
Phone
(606) 787-8348
Fax
(606) 787-8925
NPI assigned
Jan 24, 2006
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31531 KY Primary

Addresses

Primary practice location

187 Wolford Ave
Liberty, KY 42539-3187

Mailing address

187 Wolford Ave
Liberty, KY 42539-3187
Phone (606) 787-8348

Other identifiers 1

IdentifierTypeStateIssuer
64315310MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109000789 KY Practitioner - Internal Medicine 3476516642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Casey County Hospital DistrictGroup PAC ID 0749193423, 9 clinicians

Practice addresses (Care Compare)

187 Wolford Ave
Liberty, KY 42539-3278
Phone 60678762751167

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.66 of 100Reported as group
Quality
39.23
Promoting interoperability
99
Improvement activities
40
Cost
43.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31531KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Housam I Haddad Medical Practice, PLLC Internal Medicine CurrentSince Feb 21, 2012 Accepting new patients
Casey County Hospital District Current Accepting new patients
Casey County Hospital District CurrentSince Sep 15, 2003 Accepting new patients
Casey County Hospital District CurrentSince Sep 15, 2003 Accepting new patients
Adair County Hospital District Past Accepting new patients
Casey County Hospital District Past Accepting new patients
LP Liberty, LLC Past Accepting new patients

Locations

187 Wolford Ave
Liberty, KY 42539
Phone (606) 787-5044

195 N Wallace Wilkinson Blvd
Ste A
Liberty, KY 42539
Phone (606) 787-2790

199 Adams St
Liberty, KY 42539
Phone (606) 787-5044

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/caseyco-4151b385

Organizations & group practices 7

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1467422253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393187",
            "telephone_number": "606-787-8348",
            "fax_number": "606-787-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393187",
            "telephone_number": "606-787-8348",
            "fax_number": "606-787-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "HOUSAM",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "31531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64315310",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, KY

Sources for this page

Verify at the official NPI Registry.