Abduljaleel Poovathumkadavil, M.D

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

AMO395168 Issued in TN

Practice address

90 Autumn Creek LN
Apt. F
East Amherst, NY 14051-2918

Phone

(716) 800-9089

NPI assigned

Apr 19, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, TN2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Bowling Green-Warren County Community Hospital CorporationGroup PAC ID 7719899947, shared by 26 NPIs, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
• The Medical Center at Russellville Hospital, Russellville, KY, CCN 180066
• The Medical Center at Albany Hospital, Albany, KY, CCN 181333
• Caverna Memorial Hospital Hospital, Horse Cave, KY, CCN 181314
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Merit-based Incentive Payment System (MIPS)

Final score

84.94 of 100Reported as group

Quality

68.52

Promoting interoperability

100

Improvement activities

40

Cost

72.22

Merit-based Incentive Payment System (MIPS)

Final score

28.51 of 100Reported as individual

Quality

30

Improvement activities

0

Cost

33.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Dynamic Radiology Tennessee, PC

  • Diagnostic Radiology Physician
  • Clarksville, TN
  • NPI 1588387096
  Medicare reassignment NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD
• Nashville Healthcare Diagnostic Center, LLC

  • Radiology Clinic/Center
  • Nashville, TN
  • NPI 1770262503
  NPD (past)

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

• Bowling Green-Warren County Community Hospital Corporation

  • Rural Acute Care Hospital
  • Russellville, KY
  • NPI 1124868963
  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  • Critical Access Hospital
  • Horse Cave, KY
  • NPI 1356716575
  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  • Critical Access Hospital
  • Albany, KY
  • NPI 1598125502
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1790219335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 AUTUMN CREEK LN",
            "address_2": "APT. F",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512918",
            "telephone_number": "716-800-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 AUTUMN CREEK LN",
            "address_2": "APT. F",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512918",
            "telephone_number": "716-800-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOVATHUMKADAVIL",
        "first_name": "ABDULJALEEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "AMO395168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Nicole Pierce, PA-C
• Mark P Pierino, PA-C
• Allison M Plunkett
• David J Pochatko, M.D.
• Gaetano J Polizzi, DDS
• Anne Marie Elizabeth Pordan, COTA
• Matthew Pretorius, PHARMD
• Claire Morgan Prunier, DDS
• Psychology Diagnostic Services, PC
• John Jesse Rafter

• Diagnostic Radiology Physician in East Amherst, NY
• Providers in East Amherst, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.