Individual provider Active NPI

Abdul Naeem Naushad, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Poplar Bluff, MO
National Provider Identifier
1972596757
Registry record updated Mar 8, 2017
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jun 20, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
2002024819 Issued in MO
Practice address
2865 James Blvd
Poplar Bluff, MO 63901-2803
Phone
(573) 776-1100
Fax
(573) 776-1107
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 2002024819 MO Primary
Anesthesiology Physician 207L00000X 2002024819 MO

Addresses

Primary practice location

2865 James Blvd
Poplar Bluff, MO 63901-2803

Mailing address

622 Collins Dr
Ste 200
Festus, MO 63028-2077
Phone (636) 638-1506

Other identifiers 9

IdentifierTypeStateIssuer
794101OtherMOHEALTHLINK HMO
7475459OtherMOAETNA
1972596757MedicaidMO
176806OtherMOBLUE CROSS BLUE SHIELD
567896OtherMOHEALTHLINK PPO
158238001MedicaidAR
305205OtherMOGHP
00002259957OtherMOUHC
P00094934OtherMOMCRR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2002024819MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1972596757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 COLLINS DR",
            "address_2": "STE 200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282077",
            "telephone_number": "636-638-1506",
            "fax_number": "636-638-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 JAMES BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012803",
            "telephone_number": "573-776-1100",
            "fax_number": "573-776-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUSHAD",
        "first_name": "ABDUL",
        "middle_name": "NAEEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2002024819",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2002024819",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK HMO",
            "identifier": "794101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7475459",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972596757",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "176806",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PPO",
            "identifier": "567896",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158238001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "305205",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "00002259957",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P00094934",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.