NPIMap

Individual provider Active NPI

Mohammed Jamal Ahmed Bayyoumi Arisha, MD

  • Cardiovascular Disease Physician
  • Charleston, WV
National Provider Identifier
1699279794
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34055 Issued in WV
Practice address
3100 Maccorkle Ave SE Ste 101
Charleston, WV 25304-1215
Phone
(304) 388-8200
Fax
(304) 388-7010
NPI assigned
Mar 22, 2018
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34055 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE Ste 101
Charleston, WV 25304-1215

Mailing address

3100 Maccorkle Ave SE Ste 101
Charleston, WV 25304-1215
Phone (304) 388-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20250205001860 WV Practitioner - Internal Medicine 1153672563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Nov 21, 2024 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Nov 21, 2024 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 101
Charleston, WV 25304
Phone (304) 388-5395

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

3200 Maccorkle Ave SE
Bldg 4TH
Charleston, WV 25304

3200 Maccorkle Ave SE
Fl 4
Charleston, WV 25304
Phone (304) 388-5590

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

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1699279794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041215",
            "telephone_number": "304-388-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041215",
            "telephone_number": "304-388-8200",
            "fax_number": "304-388-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARISHA",
        "first_name": "MOHAMMED",
        "middle_name": "JAMAL AHMED BAYYOUMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "34055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.