NPIMap

Individual provider Active NPI

Nader Bishara Ailabouni, DO

  • Family Medicine Physician
  • Bettendorf, IA
National Provider Identifier
1497728661
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49646 Issued in MN
Practice address
4321 53Rd Ave
Bettendorf, IA 52722-1269
Phone
(563) 421-5300
Fax
(563) 421-5309
NPI assigned
Feb 8, 2006
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49646 MN Primary

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nader.ailabouni@direct.genesishealth.com Direct
Direct Messaging Address nader.ailabouni@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20041217000350 IA Practitioner - Family Practice 8022075340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 SystemGroup PAC ID 7214841436, 217 clinicians
Quad City Physical Therapy and SpineGroup PAC ID 1850332651, 29 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Family Medicine CurrentSince Sep 4, 2018 Accepting new patients
Genesis Health System CurrentSince Sep 4, 2018 Accepting new patients
Genesis Health System Family Medicine Past 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

Locations

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

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Interoperability endpoints

  • Direct secure messaging: nader.ailabouni@direct.genesishealth.com

Organizations & group practices 8

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 6

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1497728661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221269",
            "telephone_number": "563-421-5300",
            "fax_number": "563-421-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221269",
            "telephone_number": "563-421-5300",
            "fax_number": "563-421-5309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Osborne Rd NE Ste 255",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554322768",
            "country_code": "US",
            "telephone_number": "763-236-2500",
            "fax_number": "763-236-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AILABOUNI",
        "first_name": "NADER",
        "middle_name": "BISHARA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "49646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nader.ailabouni@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4321 53rd Ave",
            "city": "Bettendorf",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527221269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nader.ailabouni@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4321 53rd Ave",
            "city": "Bettendorf",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527221269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.