Individual provider Active NPI

Fadi Abou Obeid, MD

  • Clinical Cardiac Electrophysiology Physician
  • Carbondale, IL
National Provider Identifier
1811304751
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036.142760 Issued in IL
Practice address
409 W Oak St
Carbondale, IL 62901-1464
Phone
(618) 529-4455
Fax
(618) 351-1287
NPI assigned
Jul 11, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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 5

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

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Interventional Cardiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Medical Services NFP 331 clinicians

Practice addresses (Care Compare)

409 W Oak St
Carbondale, IL 62901-1414
Phone (618) 529-4455

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334
  • Pinckneyville Community Hospital Hospital, Pinckneyville, IL, CCN 141307
  • Marshall Browning Hospital Hospital, Du Quoin, IL, CCN 141331

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair28

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220719001697 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Interventional Cardiology 0547570855 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.065268ILMDInternal Medicine Physician
036.142760ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

1239 E Main St
Carbondale, IL 62901

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565

217 S Park Ave
Ste 2
Herrin, IL 62948

3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.065268 IL
Cardiovascular Disease Physician 207RC0000X 036.142760 IL
Interventional Cardiology Physician 207RI0011X 036142760 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 036.142760 IL Primary

Addresses

Primary practice location

409 W Oak St
Carbondale, IL 62901-1464

Mailing address

409 W Oak St
Carbondale, IL 62901-1464
Phone (618) 529-4455

Other practice location 1

217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455

Other practice location 2

3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address fabouobeid61814@sih.direct-ci.com
Direct Messaging Address fabouobeid61814@sih.direct-ci.com
Direct Messaging Address fabouobeid61814@sih.direct-ci.com
Direct Messaging Address fabouobeid363799@ewd.direct.hshs.org Direct

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1811304751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011464",
            "telephone_number": "618-529-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011464",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S Park Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483611",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 W Ernestine Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595800",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABOU OBEID",
        "first_name": "FADI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.065268",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.142760",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036142760",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036.142760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fabouobeid61814@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "217 S Park Ave Ste 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fabouobeid61814@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3905 W Ernestine Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fabouobeid61814@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fabouobeid363799@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.