Individual provider Active NPI

Ahmed Bassam Salem, DO

  • Emergency Medicine Physician
  • Newport News, VA
National Provider Identifier
1497384176
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3258 Issued in AL
Practice address
500 J. Clyde Morris Blvd.
Dept of Medical Education/Annex: 2ND Floor
Newport News, VA 23601
Phone
(757) 612-7200
Fax
(757) 594-3184
NPI assigned
Apr 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 3258 AL Primary

Addresses

Primary practice location

500 J. Clyde Morris Blvd.
Dept of Medical Education/Annex: 2ND Floor
Newport News, VA 23601

Mailing address

500 J. Clyde Morris Blvd.
Dept. of Medical Education/ Annex: Second Floor
Newport News, VA 23601
Phone (757) 612-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20231017003551 AL Practitioner - Emergency Medicine 0446675284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Campbell Univ School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8087

Hospital & facility affiliations

  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3258ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority CurrentSince Sep 6, 2023 Accepting new patients
Houston County Healthcare Authority Emergency Medicine Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Medcore Associates, PLLC Current Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1497384176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 J. CLYDE MORRIS BLVD.",
            "address_2": "DEPT. OF MEDICAL EDUCATION/ ANNEX: SECOND FLOOR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23601",
            "telephone_number": "757-612-7200",
            "fax_number": "757-594-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J. CLYDE MORRIS BLVD.",
            "address_2": "DEPT OF MEDICAL EDUCATION/ANNEX: 2ND FLOOR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23601",
            "telephone_number": "757-612-7200",
            "fax_number": "757-594-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEM",
        "first_name": "AHMED",
        "middle_name": "BASSAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-05",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "3258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.