Khaled Othman Abumayaleh, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1848 Issued in TN

Practice address

1030 Hunters Crossing Lane
Alcoa, TN 37701

Phone

(865) 984-1100

Fax

(865) 984-8305

NPI assigned

Feb 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811039266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 FOX LANDING LANE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37922",
            "telephone_number": "865-671-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 HUNTERS CROSSING LANE",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "37701",
            "telephone_number": "865-984-1100",
            "fax_number": "865-984-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUMAYALEH",
        "first_name": "KHALED",
        "middle_name": "OTHMAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1848",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "1847",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A Step Ahead Orthotics and Prosthetics Inc
• Adam Alliance Transport LLC
• Afc Physicians of Tennessee, PC
• Agilitas USA, Inc (Results Physiotherapy)
• Nicholas Michael Agvent, PA-C
• Ahr (Alcoa Chiropractic Center)

• Optometrist in Alcoa, TN
• Providers in Alcoa, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.