NPIMap

Individual provider Active NPI

Ahsheema Asmaa Bacchus, MD

  • Family Medicine Physician
  • Leesburg, FL
National Provider Identifier
1699209296
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40881 Issued in SC
Practice address
32845 Radio Rd
Leesburg, FL 34788-3977
Phone
(352) 504-3453
Fax
(352) 504-3454
NPI assigned
Apr 20, 2017
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME159085 FL
Family Medicine Physician 207Q00000X 40881 SC Primary

Addresses

Primary practice location

32845 Radio Rd
Leesburg, FL 34788-3977

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Other practice location 1

300 W Front St
Liberty, SC 29657-1012
Phone (864) 843-5605

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abacchus169766@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230711002756 FL Practitioner - Family Practice 3476824707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

32845 Radio Rd
Leesburg, FL 34788-3977
Phone (352) 504-3453

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME159085FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Aug 28, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 28, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

32845 Radio Rd
Leesburg, FL 34788
Phone (352) 315-1161

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Interoperability endpoints

  • Direct secure messaging: abacchus1237796@adventhealth.direct-ci.com
  • Direct secure messaging: abacchus169766@direct.ghs.myhfn.org

Organizations & group practices 3

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1699209296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32845 RADIO RD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883977",
            "telephone_number": "352-504-3453",
            "fax_number": "352-504-3454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Front St",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "SC",
            "postal_code": "296571012",
            "country_code": "US",
            "telephone_number": "864-843-5605",
            "fax_number": "864-843-0996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "AHSHEEMA",
        "middle_name": "ASMAA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME159085",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "40881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abacchus169766@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abacchus169766@direct.ghs.myhfn.org",
            "address_1": "300 W Front St",
            "city": "Liberty",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296571012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.