Individual provider Active NPI

Romy Abboud, PA

  • Physician Assistant
  • Oxford, MS
National Provider Identifier
1720660335
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
705 Sisk Ave # 105
Oxford, MS 38655-3413
Phone
(662) 371-1326
Fax
(662) 371-1325
NPI assigned
Apr 22, 2021
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

705 Sisk Ave # 105
Oxford, MS 38655-3413

Mailing address

PO Box 1158
Oxford, MS 38655-1158
Phone (662) 371-1326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210602001571 MS Practitioner - Physician Assistant 4082013677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Belle Meade Medical LLCGroup PAC ID 0547294886, 3 clinicians
Madison Medical Dermatology, LLCGroup PAC ID 4486976552, 3 clinicians

Practice addresses (Care Compare)

108 Belle Meade PT
Flowood, MS 39232-3308

1607 Doctors Dr
Madison, MS 39110-7345
Phone (769) 300-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Medical Rheumatology, LLC PastSince Jul 1, 2014 Accepting new patients
Lyndsay R Shipp MD PLLC PastSince Nov 16, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1720660335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1158",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551158",
            "telephone_number": "662-371-1326",
            "fax_number": "662-371-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SISK AVE # 105",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553413",
            "telephone_number": "662-371-1326",
            "fax_number": "662-371-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOUD",
        "first_name": "ROMY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.