Individual provider Active NPI

Hicham Elias Maalouf, PA-C

  • Medical Physician Assistant
  • Worcester, MA
National Provider Identifier
1629545397
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA6909 Issued in MA
Practice address
26 Queen St
Worcester, MA 01610-2473
Phone
(508) 860-7800
Fax
(508) 860-7973
NPI assigned
Oct 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA6909 MA Primary

Addresses

Primary practice location

26 Queen St
Worcester, MA 01610-2473

Mailing address

26 Queen Street
Worcester, MA 01610-2573
Phone (508) 860-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190401000413 MA Practitioner - Physician Assistant 4789925793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Family Health Center of Worcester, Inc.Group PAC ID 4789670985, 94 clinicians

Practice addresses (Care Compare)

26 Queen St
Worcester, MA 01610-2473
Phone (508) 860-7800

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Worcester, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Family Health Center of Worcester, Inc. CurrentSince Apr 1, 2019 Accepting new patients

Locations

26 Queen St
Worcester, MA 01610
Phone (508) 860-7700

Interoperability endpoints

  • Direct secure messaging: hmaalouf47870@direct.ctc.masshiway.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1629545397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102573",
            "telephone_number": "508-860-7800",
            "fax_number": "508-860-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7800",
            "fax_number": "508-860-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAALOUF",
        "first_name": "HICHAM",
        "middle_name": "ELIAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-31",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.