DR. AMR E ABOULEISH M.D. NPI 1083604193
Specialist in Galveston, TX

About DR. AMR E ABOULEISH M.D.

Amr Abouleish is a provider established in Galveston, Texas and his medical specialization is Specialist with more than 34 years of experience. He graduated from University Of Texas Medical School At Houston in 1989. The NPI number of Amr Abouleish is 1083604193 and was assigned on October 2005. The practitioner's primary taxonomy code is 174400000X with license number H9181 (TX). The provider is registered as an individual and his NPI record was last updated 16 years ago.

NPI
1083604193
Provider NameDR. AMR E ABOULEISH M.D.
Location Address301 UNIVERSITY BLVD GALVESTON, TX 77555
Location Phone(409) 772-2222
Mailing Address301 UNIVERSITY BLVD GALVESTON, TX 77555
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year1989
Is Sole Proprietor?N/A
Enumeration Date10-28-2005
Last Update Date07-08-2007

Amr Abouleish is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Amr Abouleish is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with .

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.3, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.H9181
License StateTX
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. AMR E ABOULEISH M.D.
301 UNIVERSITY BLVD
GALVESTON, TX
ZIP 77555
Phone: (409) 772-2222

Get Directions


Mailing Address

DR. AMR E ABOULEISH M.D.
301 UNIVERSITY BLVD
GALVESTON, TX
ZIP 77555
Phone: (409) 772-0817
Fax: (409) 772-0885


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID3274677166
PECOS Enrollment IDI20100216000266
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 98.5
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 77
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 92.3
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 19Anesthesia for procedure on lower intestine using an endoscope (HCPCS:00810)
  • 13Anesthesia for lens surgery (HCPCS:00142)
  • 12Anesthesia for procedure on gastrointestinal tract using an endoscope (HCPCS:00740)

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
84277KMEDICARE ID-TYPE UNSPECIFIED (04)TX
F68153MEDICARE UPIN (02)TX

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1083604193
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
201631208118
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 6 + 3 + 1 + 2 + 0 + 8 + 1 + 1 + 8 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1083604193 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902804461 GERALD JOSEPH FRANKEL M.D.
Individual
Urology301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1205838612DR. HAROLD SCOTT PINE MD
Individual
Otolaryngology (Pediatric Otolaryngology)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2702
1932191160DR. CHRISTINE ANN BOODLEY RN, FNP
Individual
Nurse Practitioner (Family)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-0909
1407844483 KEVIN W JOHNSON CRNA
Individual
Nurse Anesthetist, Certified Registered301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1922097781DR. ALEXIS LYNLEY M.D.
Individual
Anesthesiology301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1821064262MS. SUZANNE ELIZABETH WARITZ ALTON N.P.
Individual
Nurse Practitioner (Family)301 UNIVERSITY BLVD UNIVERSITY OF TEXAS MEDICAL BRANCH
GALVESTON, TX 77555
(409) 772-8270
1497711477THE UNIVERSITY OF TEXAS MEDICAL BRANCH
Organization
Psychiatric Unit301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 747-9734
1366409047 ZITA SUSAN SAMUEL MD
Individual
Psychiatry & Neurology (Psychiatry)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1053361287 SHIVAIAH BALACHANDRA MD
Individual
Pediatrics (Pediatric Nephrology)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1811949167 JESSICA M SENS FNP
Individual
Nurse Practitioner (Obstetrics & Gynecology)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1336191212 KJELL N LINDGREN MD
Individual
Emergency Medicine301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-5845
1487691572MR. KODAVAYOUR S NIRMAL MD
Individual
Internal Medicine301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1568400430 SUNIL K JAIN MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1578505962DR. ERICA B KELLY M.D.
Individual
Dermatology301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1891739892DR. SHARON SMITH RAIMER M.D.
Individual
Dermatology301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 747-0890
1346278728 JOSEPH HSUAN-YEE CHANG MD
Individual
Emergency Medicine301 UNIVERSITY BLVD RT 1022
GALVESTON, TX 77555
(409) 772-2222
1982633137 SALAH AYACHI PA
Individual
Physician Assistant (Medical)301 UNIVERSITY BLVD PROVIDER ENROLLMENT -- RT. 1022
GALVESTON, TX 77555
(409) 772-2222
1225062169 PIER LUIGI DIPATRE MD
Individual
Pathology (Anatomic Pathology)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222
1518992411DR. DAVID L CALLENDER M.D.
Individual
Otolaryngology301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-1902
1982622148 OWEN BRYAN HOLLAND MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)301 UNIVERSITY BLVD
GALVESTON, TX 77555
(409) 772-2222

Frequently Asked Questions

What is Dr. Amr Abouleish M.D. NPI number?

The NPI number assigned to Dr. Amr Abouleish M.D. is 1083604193, registered as an "individual" on October 28, 2005

Where is Dr. Amr Abouleish M.D. located?

The provider is located at 301 University Blvd Galveston, Tx 77555 and the phone number is (409) 772-2222

Which is Dr. Amr Abouleish M.D. specialty?

The provider's speciality is Specialist

How many years of experience does Dr. Amr Abouleish M.D. have?

The provider has more than 34 years of experience. He graduated from University Of Texas Medical School At Houston in 1989.

What insurance does Dr. Amr Abouleish M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Amr Abouleish M.D. registered in PECOS?

Yes, as of January 10, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What are Dr. Amr Abouleish M.D. Quality Ratings?

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

What are some of the services provided by Dr. Amr Abouleish M.D.?

The most common procedures or services performed by this practitioner are: Anesthesia for procedure on lower intestine using an endoscope, Anesthesia for lens surgery and Anesthesia for procedure on gastrointestinal tract using an endoscope.

How do I update my NPI information?

The NPI record of Dr. Amr Abouleish M.D. was last updated on October 28, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]