NPIMap

Individual provider Active NPI

Wael Othman, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Bowie, MD
National Provider Identifier
1831144765
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
D0060120 Issued in MD
Practice address
4000 Mitchellville Rd
Suite B216
Bowie, MD 20716-3104
Phone
(301) 262-0020
Fax
(301) 805-1124
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X D0060120 MD
Sleep Medicine (Internal Medicine) Physician 207RS0012X D0060120 MD Primary

Addresses

Primary practice location

4000 Mitchellville Rd
Suite B216
Bowie, MD 20716-3104

Mailing address

2302 Noblewood Rd
Edgewater, MD 21037-3444
Phone (410) 956-5835

Other identifiers 1

IdentifierTypeStateIssuer
402826100MedicaidMD

Other names 1

  • Dr. Ahmd Wael Hagothmn Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111107000051 MD Practitioner - Internal MedicinePractitioner - Emergency Medicine 6608860291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

2002 Medical Pkwy
Suite 670
Annapolis, MD 21401-3277
Phone (443) 481-1150

4316 Lee Blvd
Lehigh Acres, FL 33971-1735
Phone (239) 368-7744

Hospital & facility affiliations

  • Amedisys Home Health of Maryland Home health agency, Glen Burnie, MD, CCN 217108
  • The Johns Hopkins Home Health Services, Inc Home health agency, Baltimore, MD, CCN 217081
  • Centerwell Home Health Home health agency, Columbia, MD, CCN 217071
  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0060120MDMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Jan 18, 2024 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jan 18, 2024 Accepting new patients
Riad Dakheel, M.D., P.a. Sleep Medicine Current Accepting new patients
Riad Dakheel, M.D., P.a. Sleep Medicine Current Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Calvert Health Ventures Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2002 Medical Pkwy
Ste 670
Annapolis, MD 21401
Phone (410) 481-1150

4000 Mitchellville Rd
Ste B216
Bowie, MD 20716
Phone (301) 262-0020

4000 Mitchellville Rd
Ste B218
Bowie, MD 20716
Phone (301) 262-0020

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

Interoperability endpoints

  • Direct secure messaging: wothman165581@direct.aahs.org

Organizations & group practices 7

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1831144765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 NOBLEWOOD RD",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210373444",
            "telephone_number": "410-956-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE B216",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-262-0020",
            "fax_number": "301-805-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "WAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MD",
            "license": "D0060120",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MD",
            "license": "D0060120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402826100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "888 Bestgate Rd",
            "city": "Annapolis",
            "state": "MD",
            "country_code": "US",
            "postal_code": "214013091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AHMD",
            "last_name": "HAGOTHMN",
            "middle_name": "WAEL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.