1. Home
  2. Directory
  3. Wisconsin
  4. Fort Atkinson
  5. Pediatrics
  6. NPI Profile

AKM ABUHIYA MD
NPI 1164043097
Pediatrics in Fort Atkinson, WI

Active since May 01, 2020PECOS Enrolled
500 MCMILLEN ST, FORT ATKINSON, WI 53538(920) 563-5571 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 5, 2023, May 28, 2020 (2 updates tracked since 2020).

About Akm Abuhiya Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AKM ABUHIYA MD (NPI 1164043097) is an individual pediatrics provider in Fort Atkinson, Wisconsin, licensed in Wisconsin (82334-20) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1164043097
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameAKM ABUHIYACredential: MD
Location Address500 MCMILLEN STFort Atkinson, WI 53538-1233
Mailing Address500 Mcmillen StFort Atkinson, WI 53538-1233 · (920) 563-5571
Phone(920) 563-5571
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateMay 1, 2020
Last NPPES UpdateJuly 5, 20232 updates tracked since enumeration
NPPES CertifiedJuly 5, 2023
✔ NPI 1164043097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WI · 82334-20
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
500 MCMILLEN ST, Fort Atkinson, WI 53538
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Group Health Cooperative-SCW, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Akm Abuhiya Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123482148
PECOS Enrollment IDI20260227001959
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Akm Abuhiya reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fort Healthcare, Inc.
0.3 mi
General Acute Care Hospital
611 SHERMAN AVE E
Fort Atkinson, WI 53538
  • Reassigned Medicare billing, Wisconsin enrollment
  • 298 clinicians in this Medicare group
NPI 1811916281 (920) 568-5000
Mercy Health System Corporation
20 mi
General Acute Care Hospital
1000 MINERAL POINT AVE
Janesville, WI 53548
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,155 clinicians in this Medicare group
NPI 1093768962 (608) 756-6000
Chickasaw Nation Division Of Health
704 mi
General Acute Care Hospital
1921 STONECIPHER BLVD
Ada, OK 74820
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Chickasaw Nation Division Of Health Chickasaw Nation Medical Center
  • 324 clinicians in this Medicare group
NPI 1255364923 (580) 421-4570

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53538 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRAIG SWEENEY LPC-IT
Counselor (Professional)
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 222-0154
MELANIE KOLLMANSBERGER
Social Worker
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 563-5571
CATHERINE L SWEENEY MD
Pediatrics
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 563-5571
MRS. LAURA KOENIG M.D.
Internal Medicine
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 563-5571
HERBERT TURNER WENTZIEN LPC
Counselor (Professional)
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (319) 325-7276
INTERNAL MEDICINE & PEDIATRICS, S.C.
Pediatrics
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 563-7711
WILLIAM J CANNON MD
Internal Medicine
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 563-5571
LEEANN KINNEY LPC
Counselor (Mental Health)
500 MCMILLEN ST
FORT ATKINSON, WI 53538
Jefferson County (920) 563-9542

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Akm Abuhiya's NPI number?

The NPI number for Akm Abuhiya is 1164043097. It was assigned to this individual provider in the NPPES registry on May 1, 2020.

Where is Akm Abuhiya located?

Akm Abuhiya practices at 500 Mcmillen St, Fort Atkinson, WI 53538. The listed phone number is (920) 563-5571.

What is Akm Abuhiya's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Akm Abuhiya enrolled in Medicare?

Yes. Akm Abuhiya is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Akm Abuhiya's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Akm Abuhiya reassigns Medicare benefits to 3 organizations: Fort Healthcare, Inc. (Fort Atkinson, WI), Mercy Health System Corporation (Janesville, WI) and Chickasaw Nation Division Of Health (Ada, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Akm Abuhiya's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Akm Abuhiya accept?

Health plans from Group Health Cooperative-SCW and Oscar Insurance Company list Akm Abuhiya as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Akm Abuhiya was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.