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DR. EMAD ALSHAMI M.D.
NPI 1336168848
Psychiatry & Neurology - Psychiatry in Middletown, OH

Active since July 18, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1060 SUMMIT DRIVE, SUITE B, MIDDLETOWN, OH 45042(513) 423-4546(513) 423-4548 Get Directions Write a Review

NPPES record last updated: May 12, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Emad Alshami M.d. NPPES

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

DR. EMAD ALSHAMI M.D. (NPI 1336168848) is an individual psychiatry provider in Middletown, Ohio, licensed in Ohio (35-084629) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1336168848
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. EMAD ALSHAMICredential: M.D.
Location Address1060 SUMMIT DRIVE, SUITE BMiddletown, OH 45042
Mailing Address1060 Summitt Dr, Suite BMiddletown, OH 45042-3400 · (513) 423-4546 · Fax (513) 423-4548
Phone(513) 423-4546
Fax(513) 423-4548
Sole ProprietorYes
Medical School CMSOtherGraduated 1991
Enumeration DateJuly 18, 2006
Last NPPES UpdateMay 12, 2017
✔ NPI 1336168848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in OH · 35-084629
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1060 SUMMIT DRIVE, Middletown, OH 45042
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Other Identifiers 7

OtherP001381BOH · Railroad Medicare #
Medicare UPINH88956OH
Other201167053-00OH · Bwc
Medicaid2504221OH
Other4136191OH · Medicare Id
Other000000337326OH · Anthem Id#
Other201167053OH · Tax Id#

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Emad Alshami M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547230872
PECOS Enrollment IDI20040727001591
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

5

Medicare enrollment records show Emad Alshami reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

West Central Ohio Psychiatric Care, Inc.
Same address
Psychiatry
1060 SUMMITT DR, SUITE B
Middletown, OH 45042
  • Reassigned Medicare billing, Ohio enrollment
NPI 1275552697 (513) 423-4546
Access Counseling Services LLC
1.5 mi
Community/Behavioral Health
4464 S DIXIE HWY
Middletown, OH 45005
  • Reassigned Medicare billing, Ohio enrollment
  • 32 clinicians in this Medicare group
NPI 1073884524 (513) 649-8008
Dublin Springs Physician Group, LLC
75 mi
Psychiatry
7625 HOSPITAL DR
Dublin, OH 43016
  • Reassigned Medicare billing, Ohio enrollment
  • 54 clinicians in this Medicare group
NPI 1831501584 (614) 717-1800
Psychiatric Management Services
81 mi
Psychiatry
2725 ENTERPRISE DR
Anderson, IN 46013
  • Reassigned Medicare billing, Ohio enrollment
  • 16 clinicians in this Medicare group
NPI 1942677281 (317) 870-1553
Highland Springs Physician Group, LLC
201 mi
Psychiatry
34125 SOLON RD
Solon, OH 44139
  • Reassigned Medicare billing, Ohio enrollment
  • 28 clinicians in this Medicare group
NPI 1598402117 (216) 304-3287

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
671 services136 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
597 services106 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
254 services81 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
140 services76 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
103 services97 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45042 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40

Reported Quality Measures

Advance Care Plan
100%343 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%7,740 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
100%1,085 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
100%210 patients5/55-star benchmark: 100%
Tobacco Use and Help with Quitting Among Adolescents
100%23 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Emad Alshami's NPI number?

The NPI number for Emad Alshami is 1336168848. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is Emad Alshami located?

Emad Alshami practices at 1060 Summit Drive Suite B, Middletown, OH 45042. The listed phone number is (513) 423-4546.

What is Emad Alshami's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Emad Alshami enrolled in Medicare?

Yes. Emad Alshami is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Emad Alshami's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emad Alshami reassigns Medicare benefits to 5 organizations: West Central Ohio Psychiatric Care, Inc. (Middletown, OH), Access Counseling Services LLC (Middletown, OH), Dublin Springs Physician Group, LLC (Dublin, OH), Psychiatric Management Services (Anderson, IN) and Highland Springs Physician Group, LLC (Solon, OH). 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 Emad Alshami's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emad Alshami accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Antidote Health Plan of Ohio, Inc. and 7 other insurers list Emad Alshami 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 Emad Alshami was last updated on May 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.