NPIMap

Individual provider Active NPI

Endashaw Mahmud Omer, MD

  • Gastroenterology Physician
  • Louisville, KY
National Provider Identifier
1700010675
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
45380 Issued in KY
Practice address
550 S Jackson St
Acb Building, 3Rd Floor
Louisville, KY 40202-1622
Phone
(502) 852-1384
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 45380 KY Primary
Internal Medicine Physician 207R00000X 45380 KY

Addresses

Primary practice location

550 S Jackson St
Acb Building, 3Rd Floor
Louisville, KY 40202-1622

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0320

Other identifiers 2

IdentifierTypeStateIssuer
201305190MedicaidIN
7100355500MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20150629003040 KY Practitioner - Gastroenterology 8921310244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 E Chestnut St
Suite 310
Louisville, KY 40202-5703
Phone (502) 584-8563

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy102
Upper gastrointestinal (GI) endoscopy for acid reflux297

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45380KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Internal Medicine Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 1, 2015 Accepting new patients
University of Louisville Physicians, Inc. Gastroenterology CurrentSince Jul 1, 2015 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

550 S Jackson St
Bldg 3RD
Louisville, KY 40202
Phone (502) 852-1384

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Interoperability endpoints

  • Direct secure messaging: eomer23418@uoflhealth-dm.org

Organizations & group practices 4

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1700010675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0320",
            "fax_number": "502-588-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST",
            "address_2": "ACB BUILDING, 3RD FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622",
            "telephone_number": "502-852-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMER",
        "first_name": "ENDASHAW",
        "middle_name": "MAHMUD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "45380",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "45380",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201305190",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100355500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.