Omar F Abou Ezzeddine, MD
Individual provider Active NPI Advanced Heart Failure and Transplant Cardiology Physician · Rochester, MN
NPI 1740480391 · NPPES record last updated Aug 11, 2020
Key facts
- NPI
- 1740480391
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X
- License
- 50744 (MN)
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Jul 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 26
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Advanced Heart Failure and Transplant Cardiology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mayo Clinic Health System-Southwest Minnesota Region
Mayo Clinic
Mayo Clinic Health System-Southeast Minnesota Region
Practice addresses (Care Compare)
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
1216 2ND St SW
Rochester, MN 55902-1906
Phone (507) 255-5123
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
200 1St SWST
Rochester, MN 55905-0001
201 W Ctr St
Rochester, MN 55902-3003
Phone (507) 255-5123
2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-1120
2250 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-3850
404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384
Hospital & facility affiliations
- Mayo Clinic Hospital Rochester
- Mayo Clinic Health System - Albert Lea and Austin
- Mayo Clinic Health System - Mankato
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081204000023 | MN | Practitioner - Advanced Heart Failure and Transplant Cardiology |
8123189545 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Fairmont | Current |
Accepting new patients | |
| Mayo Clinic | Current |
Accepting new patients | |
| Mayo Clinic | Current | Accepting new patients | |
| Mayo Clinic | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Hospital-Rochester | Past | Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients | |
| Mayo Clinic | Past | Accepting new patients |
Locations
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
201 Center St W
Rochester, MN 55902
Phone (507) 266-7405
Interoperability endpoints
- oabouezzeddine130592@ehrdirect.mayoclinicmsg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 50744 | MN | |
| Cardiovascular Disease Physician | 207RC0000X | 50744 | MN | |
| Advanced Heart Failure and Transplant Cardiology Physician | 207RA0001X | 50744 | MN | Yes |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oabouezzeddine130592@ehrdirect.mayoclinicmsg.org |
Other providers in Rochester, MN
- Kamal Abi Mosleh
- Ability Building Center Inc
- Ability Care Transportation Services
- Jad Pierre Abimansour
- Mohamad Khair M M KH Abou Chaar
- Houssam Abou Mourad
- Tarek M Abouel Leil
- Anu Abraham
- Helayna Abraham
- Jacob Isaac Abraham
All providers in Rochester, MN · Advanced Heart Failure and Transplant Cardiology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.