NPIMap

Individual provider Active NPI

Alaa Mabrouk Salem Omar, MD, PHD, FACC

  • Interventional Cardiology Physician
  • McComb, MS
National Provider Identifier
1962913178
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
33201 Issued in MS
Practice address
303 Marion Ave
McComb, MS 39648-2707
Phone
(601) 249-1350
Fax
(601) 249-1339
NPI assigned
Oct 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 33201 MS Primary

Addresses

Primary practice location

303 Marion Ave
McComb, MS 39648-2707

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other practice location 1

1065 E Broad St
Monticello, MS 39654-7703
Phone (601) 249-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240715003383 MS Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9739624651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Mississippi Regional Medical CenterGroup PAC ID 5193633907, 82 clinicians

Practice addresses (Care Compare)

303 Marion Ave
McComb, MS 39648-2707
Phone (601) 249-1350

Hospital & facility affiliations

  • Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097
  • Lawrence County Hospital Cah Hospital, Monticello, MS, CCN 251305
  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting15
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center Current Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Southwest Mississippi Regional Medical Center Past Accepting new patients
Southwest Ms Regional Medical Center Past Accepting new patients

Locations

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

303 Marion Ave
McComb, MS 39648
Phone (601) 249-1350

1065 E Broad St
Monticello, MS 39654
Phone (601) 249-1350

Interoperability endpoints

  • Direct secure messaging: aomar5289149@direct.casso.us.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1507939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1962913178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482707",
            "telephone_number": "601-249-1350",
            "fax_number": "601-249-1339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "MS",
            "postal_code": "396547703",
            "country_code": "US",
            "telephone_number": "601-249-1350",
            "fax_number": "601-249-1339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMAR",
        "first_name": "ALAA",
        "middle_name": "MABROUK SALEM",
        "name_prefix": "Dr.",
        "credential": "MD, PHD, FACC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-14",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "33201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.