Individual provider Active NPI

Sam J Badran, MD

  • Gynecology Physician
  • Point Pleasant, WV
National Provider Identifier
1639745201
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
30366 Issued in WV
Practice address
2520 Valley Dr
Point Pleasant, WV 25550-2092
Phone
(304) 675-4340
Fax
(304) 675-6911
NPI assigned
Jun 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 30366 WV Primary

Addresses

Primary practice location

2520 Valley Dr
Point Pleasant, WV 25550-2092

Mailing address

4433 Roslyn Rd
Downers Grove, IL 60515-5804
Phone (773) 818-2692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20210629001375 WV Practitioner - Obstetrics/Gynecology 4284035213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Point Pleasant Physician Billing Services 36 clinicians

Practice addresses (Care Compare)

2520 Valley Dr
PT Pleasant, WV 25550-2031
Phone 30467543401249

Hospital & facility affiliations

  • Rivers Health Hospital, Point Pleasant, WV, CCN 510012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30366WVMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Point Pleasant Physician Billing Services CurrentSince Aug 1, 2021 Accepting new patients

Locations

2520 Valley Dr
Ste 113
Pt Pleasant, WV 25550
Phone (304) 675-1020

2520 Valley Dr
Pt Pleasant, WV 25550
Phone (304) 675-1020

Interoperability endpoints

  • Direct secure messaging: sam.badron@pvhhealth.direct.wvhin.org

Organizations & group practices 1

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1639745201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 ROSLYN RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155804",
            "telephone_number": "773-818-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 VALLEY DR",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255502092",
            "telephone_number": "304-675-4340",
            "fax_number": "304-675-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRAN",
        "first_name": "SAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WV",
            "license": "30366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Pleasant, WV

Sources for this page

Verify at the official NPI Registry.