Individual provider Active NPI

Fuad Bassam Bohsali, MD

  • Internal Medicine Physician
  • Durham, NC
National Provider Identifier
1972940112
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2017-01961 Issued in NC
Practice address
3643 N Roxboro St
Durham, NC 27704-2702
Phone
(919) 470-8461
NPI assigned
May 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2017-01961 NC Primary
Internal Medicine Physician 207R00000X D81093 MD

Addresses

Primary practice location

3643 N Roxboro St
Durham, NC 27704-2702

Mailing address

3643 N Roxboro St
Durham, NC 27704-2702

Other identifiers 1

IdentifierTypeStateIssuer
2017-01961MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180104002104 NC Practitioner - Hospitalist 4082908033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Eastern Virginia Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

3643 N Roxboro St
Durham, NC 27704-2702
Phone (919) 470-5356

Hospital & facility affiliations

  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-01961NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Duke University Health System, Inc. Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients

Locations

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

Interoperability endpoints

  • Direct secure messaging: fbohsali393530@direct.medicine.duke.edu

Organizations & group practices 2

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 2

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": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1972940112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHSALI",
        "first_name": "FUAD",
        "middle_name": "BASSAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-29",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-01961",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D81093",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017-01961",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.