Individual provider Active NPI

Nader Aboul-Fettouh, MD

  • MOHS-Micrographic Surgery Physician
  • Allen, TX
National Provider Identifier
1508360298
Registry record updated Jun 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
U0542 Issued in TX
Practice address
1150 N Watters Rd Ste 105
Allen, TX 75013-5536
Phone
(469) 331-3242
Fax
(469) 331-3243
NPI assigned
Mar 19, 2018
Last updated
Jun 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X U0542 TX Primary

Addresses

Primary practice location

1150 N Watters Rd Ste 105
Allen, TX 75013-5536

Mailing address

1150 N Watters Rd Ste 105
Allen, TX 75013-5536
Phone (469) 331-3242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230901000098 TX Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 7214317197 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Texas Southwestern Medical School at Dallas, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1150 N Watters Rd
Suite 105
Allen, TX 75013-5536
Phone (469) 331-3242

5310 Harvest Hill Rd
Suite 130
Dallas, TX 75230-5806
Phone (214) 919-3150

Merit-based Incentive Payment System (MIPS)

Final score
86.69 of 100Reported as group
Quality
87.43
Improvement activities
40
Cost
72.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision26
Removal of skin lesions52
Removal of skin cancer145
Skin biopsy27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clearlife PLLC CurrentSince Feb 23, 2025 Accepting new patients
The Woodlands Skin Surgery Center PA Mohs-Micrographic Surgery CurrentSince Sep 1, 2023 Accepting new patients
The Woodlands Skin Surgery Center PA Mohs-Micrographic Surgery CurrentSince Oct 29, 2023 Accepting new patients
Oliver Street 5.01(a) Inc. Mohs-Micrographic Surgery CurrentSince Jul 1, 2025 Accepting new patients
Blue Ribbon Dermatology PLLC Mohs-Micrographic Surgery CurrentSince May 1, 2025 Accepting new patients
Dermatology Associates Mohs-Micrographic Surgery PastSince Jul 1, 2025 Accepting new patients

Locations

1150 N Watters Rd
Ste 105
Allen, TX 75013
Phone (469) 331-3242

5310 Harvest Hill Rd
Ste 130
Dallas, TX 75230
Phone (214) 919-3133

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

6117 Berkshire Ln
Dallas, TX 75225
Phone (214) 373-3376

13325 Hargrave Rd
Ste 130140
Houston, TX 77070
Phone (281) 364-8844

5030 Tennyson Pkwy
Ste 200
Plano, TX 75024

8850 Six Pines Dr
Ste 100
Shenandoah, TX 77380
Phone (281) 364-8844

3786 FM 1488 Rd
Ste 200
The Woodlands, TX 77384
Phone (281) 364-8844

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: naboulfettouh@directaddress.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1508360298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N WATTERS RD STE 105",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135536",
            "telephone_number": "469-331-3242",
            "fax_number": "469-331-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N WATTERS RD STE 105",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135536",
            "telephone_number": "469-331-3242",
            "fax_number": "469-331-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOUL-FETTOUH",
        "first_name": "NADER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "U0542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.