NPIMap

Individual provider Active NPI

Issa Abedmahmoud, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Herrin, IL
National Provider Identifier
1528042975
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036097793 Issued in IL
Practice address
3020 S Park Ave
Herrin, IL 62948-3721
Phone
(618) 988-1877
Fax
(618) 988-8578
NPI assigned
Nov 30, 2005
Last updated
Nov 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036097793 IL Primary

Addresses

Primary practice location

3020 S Park Ave
Herrin, IL 62948-3721

Mailing address

PO Box 1096
Herrin, IL 62948-1096
Phone (618) 988-1877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20070403000227 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 1153425061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahuja Bariatric and BeyondGroup PAC ID 6901289347, 6 clinicians

Practice addresses (Care Compare)

4230 Lincolnshire Dr
Suite a
Mount Vernon, IL 62864-2189
Phone (618) 315-6466

900 N Washington St
Du Quoin, IL 62832-1230

900 N Washington St
Du Quoin, IL 62832-1233
Phone (618) 542-2146

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.82 of 100Reported as group
Quality
100
Improvement activities
40
Cost
69.79

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahuja Bariatric & Beyond Endocrinology, Diabetes & Metabolism CurrentSince May 15, 2024 Accepting new patients
Marshall Browning Hospital Association CurrentSince Sep 2, 2018 Accepting new patients
Marshall Browning Hospital Association CurrentSince Sep 2, 2018 Accepting new patients
Southern Illinois Gi Specialists LLC PastSince Jul 24, 2015 Accepting new patients
Marshall Browning Hospital Association Past Accepting new patients

Locations

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

3020 S Park Ave
Herrin, IL 62948
Phone (618) 529-0120

2 Good Samaritan Way
Ste 200
Mount Vernon, IL 62864
Phone (618) 899-3869

4230 Lincolnshire Dr
Ste A
Mount Vernon, IL 62864
Phone (618) 244-6222

Interoperability endpoints

  • Direct secure messaging: ahujabariatricandbeyond.issaabedmahmoud@153356.advancedmd-direct.com
  • FHIR API: https://fa120b5c-6699-49eb-9b43-fa51a183b3cb.gastro.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: issa.abed@mbhdq.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1528042975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1096",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629481096",
            "telephone_number": "618-988-1877",
            "fax_number": "618-988-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483721",
            "telephone_number": "618-988-1877",
            "fax_number": "618-988-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEDMAHMOUD",
        "first_name": "ISSA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036097793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.