Nader Bishara Ailabouni, DO
Individual provider Active NPI Family Medicine Physician · Bettendorf, IA
NPI 1497728661 · NPPES record last updated Apr 29, 2021
Key facts
- NPI
- 1497728661
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 49646 (MN)
- Practice address
- 4321 53Rd Ave
Bettendorf, IA 52722-1269 - Phone
- (563) 421-5300
- Fax
- (563) 421-5309
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Genesis Health System
Quad City Physical Therapy and Spine
Practice addresses (Care Compare)
1345 W Central Park Ave
Mercyone Genesis Family Medical Cen
Davenport, IA 52804-1844
Phone (563) 421-4400
3200 W Kimberly Rd
Davenport, IA 52806-3059
Phone (563) 421-0100
5254 Utica Ridge Rd
Davenport, IA 52807-3872
Phone (563) 359-3799
619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487
Hospital & facility affiliations
- Genesis Vna
- In-Home Care Connection Home Health Services
- Mercyone Genesis
- Genesis HLTH System Dba Genesis MDL Ctr-Illini
- Genesis Medical Center-Davenport
- Mercyone Genesis Dewitt Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 12 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041217000350 | IA | Practitioner - Family Practice | 8022075340 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Health System | Current |
Accepting new patients | |
| Genesis Health System | Family Medicine | Current |
Accepting new patients |
| Genesis Medical Education Foundation Inc | Family Medicine | Past | Accepting new patients |
| Genesis Health System | Family Medicine | Past | Accepting new patients |
| Columbia Park Medical Group, PA | Family Medicine | Past | Accepting new patients |
| Genesis Health System | Family Medicine | Past | Accepting new patients |
Locations
210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436
1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400
1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287
619 5th St
Durant, IA 52747
Phone (563) 785-4487
Interoperability endpoints
- nader.ailabouni@direct.genesishealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 49646 | MN | Yes |
Addresses
Primary practice location
4321 53Rd Ave
Bettendorf, IA 52722-1269
Mailing address
4321 53Rd Ave
Bettendorf, IA 52722-1269
Phone (563) 421-5300
Other practice location 1
500 Osborne Rd NE Ste 255
Fridley, MN 55432-2768
Phone (763) 236-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 503938000 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nader.ailabouni@direct.genesishealth.com | Direct | |
| Direct Messaging Address | nader.ailabouni@direct.genesishealth.com | Direct |
Other providers in Bettendorf, IA
- Neeru Agarwal
- Neeru Aggarwal
- Steven J Aguilar
- Anita Ahuja
- Vinti Ahuja
- Kelly J Airey
- Amenah Al-Juboori
- Alblevins Chiropractic, Inc.
- Melissa Alexander
- Alisha Jones Podiatry
All providers in Bettendorf, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.