NPIMap

Individual provider Active NPI

Mamoun R Pacha, M.D.

  • Specialist
  • Sylacauga, AL
National Provider Identifier
1871586453
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
8767 Issued in AL
Practice address
16 S Douglas Ave
Sylacauga, AL 35150-2951
Phone
(256) 245-2269
Fax
(256) 245-2260
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 8767 AL Primary

Addresses

Primary practice location

16 S Douglas Ave
Sylacauga, AL 35150-2951

Mailing address

16 S Douglas Ave
Sylacauga, AL 35150-2951
Phone (256) 245-2269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100204000490 AL Practitioner - Urology 0446213276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 W Hickory St
Sylacauga, AL 35150-2913
Phone (256) 401-4467

9518 US Hwy 231
Rockford, AL 35136-5214
Phone (256) 377-4366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.03 of 100Reported as group
Quality
58.1
Promoting interoperability
96
Improvement activities
40
Cost
72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Sylacauga Health Care Authority CurrentSince Feb 15, 2021 Accepting new patients
The Sylacauga Health Care Authority CurrentSince Feb 15, 2021 Accepting new patients
The Sylacauga Health Care Authority Past Accepting new patients

Locations

9518 US Highway 231
Rockford, AL 35136
Phone (256) 377-4366

315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000

16 S Douglas Ave
Sylacauga, AL 35150
Phone (205) 245-2269

Networks

  • bcbs alabama network 01B0
  • bcbs alabama network 01H0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01G0

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Coosa Valley Medical CenterSylacauga, AL, CCN 010164 Hospital Corporate Director Aug 1, 2006
Coosa Valley Medical CenterSylacauga, AL, CCN 01S164 Hospital Corporate Director Aug 1, 2006
Coosa Valley HospiceSylacauga, AL, CCN 011661 Hospice Corporate Director Aug 1, 2006
Davis Family MedicineSylacauga, AL, CCN 018506 Rural health clinic Corporate Director Jul 1, 2023
Nix Family MedicineChildersburg, AL, CCN 018503 Rural health clinic Corporate Director Jul 1, 2023

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1871586453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 S DOUGLAS AVE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502951",
            "telephone_number": "256-245-2269",
            "fax_number": "256-245-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S DOUGLAS AVE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502951",
            "telephone_number": "256-245-2269",
            "fax_number": "256-245-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHA",
        "first_name": "MAMOUN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "8767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.