Individual provider Active NPI

Hythem Abad, DO

  • Emergency Medicine Physician
  • Portage, WI
National Provider Identifier
1548799455
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
81232-21 Issued in WI
Practice address
2817 New Pinery Rd
Portage, WI 53901-9240
Phone
(608) 742-4131
NPI assigned
Jun 6, 2017
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1374 WV
Emergency Medicine Physician 207P00000X 81232-21 WI Primary

Addresses

Primary practice location

2817 New Pinery Rd
Portage, WI 53901-9240

Mailing address

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210818002011 WV Practitioner - Emergency Medicine 9032461165 Reassigns benefits to 1 organization
I20230927001363 WI Practitioner - Emergency Medicine 9032461165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.7 of 100Reported as group
Quality
91.14
Promoting interoperability
100
Improvement activities
40
Cost
77.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81232-21WIMDEmergency Medicine Physician
1374WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Savior Healthcare, Inc. Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Charleston Area Medical Center, Inc. Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 3, 2021 Accepting new patients
Charleston Area Medical Center, Inc. Emergency Medicine CurrentSince Aug 3, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

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 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": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1548799455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABAD",
        "first_name": "HYTHEM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "1374",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81232-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

Verify at the official NPI Registry.