ALYSSA ABDELNOUR MD
NPI 1417717885
Student in an Organized Health Care Education/Training Program in San Bernardino, CA

Q: What is Alyssa Abdelnour's NPI number?

The NPI number for Alyssa Abdelnour is 1417717885. It was assigned to this individual provider in the NPPES registry on March 21, 2024.

Q: What is Alyssa Abdelnour's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Alyssa Abdelnour was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 21, 2024PECOS Enrolled

2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404(909) 883-8711 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Alyssa Abdelnour Md NPPES

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

ALYSSA ABDELNOUR MD (NPI 1417717885) is an individual student in an organized health care education/training program in San Bernardino, California and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417717885

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameALYSSA ABDELNOURCredential: MD

Location Address2101 N WATERMAN AVESan Bernardino, CA 92404-4836

Mailing Address2101 N Waterman AveSan Bernardino, CA 92404-4836

Phone(909) 883-8711

Sole ProprietorNo

Enumeration DateMarch 21, 2024

NPPES CertifiedMarch 19, 2024

✔ NPI 1417717885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X

2101 N WATERMAN AVE, San Bernardino, CA 92404

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Other Providers at the Same Location NPPES 20

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

NICHOLAS WALTHER PA-C

Physician Assistant (Medical)