NPIMap

Individual provider Active NPI

Ahmad H Altabbaa, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1952350233
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27191 Issued in TN
Practice address
3950 New Covington Pike
Suite 290
Memphis, TN 38128-2595
Phone
(901) 791-2764
Fax
(901) 791-2783
NPI assigned
May 6, 2006
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 27191 TN
Internal Medicine Physician 207R00000X 27191 TN Primary

Addresses

Primary practice location

3950 New Covington Pike
Suite 290
Memphis, TN 38128-2595

Mailing address

PO Box 3836
Cordova, TN 38088-3836
Phone (901) 791-2764

Other identifiers 1

IdentifierTypeStateIssuer
30992701MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040706000458 TN Practitioner - HospitalistPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9931186251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians

Practice addresses (Care Compare)

3960 New Covington Pike
Memphis, TN 38128-2504
Phone (901) 516-5741

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Methodist Inpatient Physicians LLC Internal Medicine CurrentSince Jan 4, 2017 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Tennessee Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
United Emergency Services of Tennessee, LLC Emergency Medicine Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

1211 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 287-5182

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

Interoperability endpoints

  • Direct secure messaging: aaltabbaa21672@mlh.direct-ci.com

Organizations & group practices 6

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 3

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1952350233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3836",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380883836",
            "telephone_number": "901-791-2764",
            "fax_number": "901-791-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 NEW COVINGTON PIKE",
            "address_2": "SUITE 290",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282595",
            "telephone_number": "901-791-2764",
            "fax_number": "901-791-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTABBAA",
        "first_name": "AHMAD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "27191",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "27191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30992701",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.