NPIMap

Individual provider Active NPI

Omar A Al-Abboud, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1740693449
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T2098 Issued in TX
Practice address
909 9TH Ave Ste 400
Fort Worth, TX 76104-3932
Phone
(817) 725-7880
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2017021747 MO
Internal Medicine Physician 207R00000X 324854 LA
Internal Medicine Physician 207R00000X 036153754 IL
Hospitalist Physician 208M00000X 036153754 IL
Hospitalist Physician 208M00000X 2017021747 MO
Internal Medicine Physician 207R00000X T2098 TX Primary

Addresses

Primary practice location

909 9TH Ave Ste 400
Fort Worth, TX 76104-3932

Mailing address

1000 W Cannon St
Fort Worth, TX 76104-3029
Phone (817) 725-7900

Other practice location 1

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

Other practice location 2

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Other practice location 3

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1328

Other practice location 4

222 S Woods Mill Rd
Chesterfield, MO 63017-3625
Phone (314) 205-6050

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX, LA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200910002352 IL Practitioner - HospitalistPractitioner - Internal Medicine 9638471493 Reassigns benefits to 1 organization
I20200922000932 TX Practitioner - Internal Medicine 9638471493 Reassigns benefits to 2 organizations
I20200922001035 LA Practitioner - Internal Medicine 9638471493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Idocsweb LLCGroup PAC ID 5092137679, 2 clinicians

Practice addresses (Care Compare)

333 Texas St
Suite 1300
Shreveport, LA 71101-3783
Phone (800) 990-7993

5465 Legacy Dr
Suite 650
Plano, TX 75024-4171
Phone (214) 914-8765

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324854LAMDInternal Medicine Physician
2017021747MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Oct 1, 2020 Accepting new patients
PPG Health, PA Internal Medicine CurrentSince Apr 17, 2023 Accepting new patients
Fairview Heights Medical Group SC Current Accepting new patients
Idocsweb LLC Internal Medicine CurrentSince Aug 15, 2020 Accepting new patients
Ai Interventional LLC Internal Medicine PastSince Oct 22, 2025 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

333 Texas St
Ste 1300
Shreveport, LA 71101
Phone (318) 723-9341

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

265 SE John Jones Dr
Ste 102
Burleson, TX 76028
Phone (817) 284-9225

419 S Cockrell Hill Rd
Duncanville, TX 75116
Phone (410) 552-4800

909 9th Ave
Ste 400
Fort Worth, TX 76104
Phone (817) 338-9291

3848 North Tarrant Pkwy
Ste 160
Fort Worth, TX 76244
Phone (817) 725-7880

1000 W Cannon St
Ft Worth, TX 76104
Phone (817) 725-7900

9947 N MacArthur Blvd
Ste 150
Irving, TX 75063
Phone (817) 406-2064

5465 Legacy Dr
Ste 650
Plano, TX 75024
Phone (214) 778-7690

5700 Granite Pkwy
Ste 200
Plano, TX 75024
Phone (214) 387-6011

Interoperability endpoints

  • Direct secure messaging: oalabboud1083421@direct.sw.org

Organizations & group practices 5

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1740693449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043029",
            "telephone_number": "817-725-7900",
            "fax_number": "682-207-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 9TH AVE STE 400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043932",
            "telephone_number": "817-725-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622265360",
            "country_code": "US",
            "telephone_number": "618-257-6220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 N Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312329",
            "country_code": "US",
            "telephone_number": "314-996-5772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 S Woods Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630173625",
            "country_code": "US",
            "telephone_number": "314-205-6050",
            "fax_number": "314-434-5939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-ABBOUD",
        "first_name": "OMAR",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2017021747",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "324854",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036153754",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036153754",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2017021747",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T2098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.