Individual provider Active NPI

Ammar F Nasrallah, MD

  • Infectious Disease Physician
  • Madison, WI
National Provider Identifier
1700841566
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
53775-020 Issued in WI
Practice address
1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone
(608) 252-8000
Fax
(608) 283-7318
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 53775-020 WI Primary

Addresses

Primary practice location

1313 Fish Hatchery Rd
Madison, WI 53715-1911

Mailing address

1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1700841566MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address anasrallah258887@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100629000944 WI Practitioner - Infectious Disease 4486665064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (608) 260-6000

225 Church St
Stoughton, WI 53589-1801
Phone (608) 877-2777

2805 Hunters TRL
Portage, WI 53901-3429
Phone (608) 745-5900

2825 Hunters TRL
Portage, WI 53901-3429
Phone (608) 742-5522

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

707 14TH St
Baraboo, WI 53913-1539
Phone (608) 356-1400

740 Reena Ave
Fort Atkinson, WI 53538-3145
Phone (920) 563-0888

752 N High Point Rd
Madison, WI 53717-2236
Phone (608) 824-4000

753 N Main St
Oregon, WI 53575-1003
Phone (608) 835-2222

833 S Iowa St
Suite 102
Dodgeville, WI 53533-1900
Phone (608) 935-3301

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53775-020WIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Infectious Disease CurrentSince May 19, 2010 Accepting new patients
Dean Health Systems, Inc. CurrentSince May 19, 2010 Accepting new patients
South Texas Oncology and Hematology, PLLC Past Accepting new patients

Locations

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1700841566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASRALLAH",
        "first_name": "AMMAR",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WI",
            "license": "53775-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700841566",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anasrallah258887@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "anasrallah258887@direct-ehr-ssmhc.com",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.