Individual provider Active NPI

Mahmoud Alameddine

  • Urology Physician
  • Ottumwa, IA
National Provider Identifier
1730595778
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD-44961 Issued in IA
Practice address
1003 Pennsylvania Ave
Ottumwa, IA 52501-2108
Phone
(641) 684-3208
Fax
(641) 684-3209
NPI assigned
Jul 10, 2014
Last updated
Jul 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN19840 FL
Urology Physician 208800000X MD-44961 IA Primary

Addresses

Primary practice location

1003 Pennsylvania Ave
Ottumwa, IA 52501-2108

Mailing address

1003 Pennsylvania Ave
Ottumwa, IA 52501-2108
Phone (641) 684-3208

Other practice location 1

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 355-1123

Other practice location 2

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 355-1123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20180710000816 IA Practitioner - Urology 1052667854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ottumwa Health Group LLCGroup PAC ID 3971629924, 26 clinicians

Practice addresses (Care Compare)

1001 Pennsylvania Ave
Ottumwa, IA 52501-2186
Phone (641) 684-2466

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN19840FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ottumwa Health Group LLC CurrentSince Aug 1, 2018 Accepting new patients
Ottumwa Health Group LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

1001 Pennsylvania Ave
Ofc
Ottumwa, IA 52501

1003 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 682-2514

1013 Pennsylvania Ave
Ste E
Ottumwa, IA 52501
Phone (641) 684-3111

Interoperability endpoints

  • Direct secure messaging: mahmoud.alameddine.1@6270.direct.athenahealth.com

Organizations & group practices 2

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 5

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1730595778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012108",
            "telephone_number": "641-684-3208",
            "fax_number": "641-684-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012108",
            "telephone_number": "641-684-3208",
            "fax_number": "641-684-3209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-355-1123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-355-1123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALAMEDDINE",
        "first_name": "MAHMOUD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-10",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN19840",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IA",
            "license": "MD-44961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

Verify at the official NPI Registry.