Mustapha Kamel Abouda, MD

Key facts

NPI

1477654697

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

M020550567 (NM)

Practice address

1302 E Calle de Merced
Espanola, NM 87532

Phone

(505) 753-9292

Fax

(505) 753-1866

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 3

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

• Los Alamos Physician Practices LLC Family Medicine Physician · Los Alamos, NM · NPI 1750330510
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · NM
• Los Alamos Physician Practices, LLC Surgery Physician · Los Alamos, NM · NPI 1801075783
  NPD
• Taos Health Systems, Inc., Holy Cross Hospital Critical Access Hospital · Taos, NM · NPI 1902338049
  NPD (past)

Hospital & facility affiliations 4

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

• Ambercare Home Health Care Corporation Home Health Agency · Belen, NM · NPI 1336117621
  Care Compare affiliation Home health agency
• PHC-Los Alamos Inc Rural Acute Care Hospital · Los Alamos, NM · NPI 1285701623
  Care Compare affiliation Hospital
• Presbyterian Healthcare Services Rural Acute Care Hospital · Espanola, NM · NPI 1154307593
  Care Compare affiliation Hospital
• St Vincent Hospital General Acute Care Hospital · Santa Fe, NM · NPI 1578587150
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Los Alamos Physician Practices LLC (19 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ambercare Home Health Home health agency · Belen, NM · CCN 327123
• Los Alamos Medical Center Hospital · Los Alamos, NM · CCN 320033
• Presbyterian Espanola Hospital Hospital · Espanola, NM · CCN 320011
• Christus St Vincent Regional Medical Center Hospital · Santa Fe, NM · CCN 320002

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100 (group)

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mustapha.abouda.1@19849.direct.athenahealth.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 13, 2008.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208044800000",
    "number": "1477654697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2219",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322219",
            "telephone_number": "505-753-9292",
            "fax_number": "505-753-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 E CALLE DE MERCED",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "87532",
            "telephone_number": "505-753-9292",
            "fax_number": "505-753-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOUDA",
        "first_name": "MUSTAPHA",
        "middle_name": "KAMEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "M020550567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN",
            "identifier": "202005111",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98800825",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE SALUD",
            "identifier": "SX159",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE COMMERCIAL",
            "identifier": "90382",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM009X52",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMYPR0070730",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Espanola, NM · Family Medicine Physician in New Mexico