HAITHAM ABUGHNIA MD
NPI 1437346889
Internal Medicine in Clarks Summit, PA

Q: What is Haitham Abughnia's NPI number?

The NPI number for Haitham Abughnia is 1437346889. It was assigned to this individual provider in the NPPES registry on October 1, 2007.

Q: What is Haitham Abughnia's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Haitham Abughnia was last updated on November 8, 2023. 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 October 01, 2007PECOS EnrolledAccepts Medicare Assignment

94.32/100

CMS Quality Rating

401 N STATE ST, CLARKS SUMMIT, PA 18411(570) 587-7817(570) 587-7815 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Haitham Abughnia Md NPPES

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

HAITHAM ABUGHNIA MD (NPI 1437346889) is an individual internal medicine provider in Clarks Summit, Pennsylvania, licensed in Pennsylvania (MD432322) and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS, is affiliated with Geisinger-community Medical Center, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1437346889

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameHAITHAM ABUGHNIACredential: MD

Location Address401 N STATE STClarks Summit, PA 18411-1061

Mailing Address401 N State StClarks Summit, PA 18411-1061 · (570) 587-7817 · Fax (570) 587-7815

Phone(570) 587-7817

Fax(570) 587-7815

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateOctober 1, 2007

Last NPPES UpdateNovember 8, 2023

NPPES CertifiedNovember 8, 2023

✔ NPI 1437346889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD432322

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

401 N STATE ST, Clarks Summit, PA 18411

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Other Identifiers 1

Medicaid102017180PA

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Haitham Abughnia Md 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 ID7810084670

PECOS Enrollment IDI20071026000337

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.

Areas of Expertise CMS Part B claims 27

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

2,041 services1,250 patients

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.

1,621 services1,002 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

539 services174 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

532 services508 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.

421 services387 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

351 services90 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

222 services197 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

158 services158 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

147 services147 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

146 services146 patients

Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502

Technetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.

145 services143 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

98 services84 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

91 services91 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

84 services76 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days 93244

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

69 services69 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

51 services49 patients

Ultrasound of heart blood flow, valves and chambers 93320

An ultrasound of your heart, also known as an echocardiogram, is a test that uses sound waves to create detailed images of your heart. It helps doctors check the health of your heart's chambers, valves, and blood flow.

51 services49 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

51 services49 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

46 services37 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

46 services28 patients

Ultrasound of heart, follow-up 93308

37 services29 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

35 services29 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

32 services27 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

27 services25 patients

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days 93242

This procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.

23 services23 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system 93288

An evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.

14 services12 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Geisinger-Community Medical Center

Acute Care Hospitals · Scranton, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390001

Location1822 Mulberry StreetScranton, PA 18510 · Lackawanna County

Emergency services Birthing friendly

Wayne Memorial Hospital

Acute Care Hospitals · Honesdale, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390125

Location601 Park StreetHonesdale, PA 18431 · Wayne County

Emergency services Birthing friendly

Regional Hospital Of Scranton

Acute Care Hospitals · Scranton, PA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number390237

Location746 Jefferson AvenueScranton, PA 18501 · Lackawanna County

Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390270

Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County

Emergency services Birthing friendly

Barnes-Kasson County Hospital

Critical Access Hospitals · Susquehanna, PA

OwnershipVoluntary non-profit - Private

CMS Certification Number391309

Location2872 Turnpike StreetSusquehanna, PA 18847 · Susquehanna County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18411 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

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.

94.32/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

88.65

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%676 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%748 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606

DME-Other DME · category DE013N

1 supplier29 claims29 services$2,254.62 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

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

DR. SAMIR BIPIN PANCHOLY M.D.

Internal Medicine (Interventional Cardiology)

401 N STATE ST
CLARKS SUMMIT, PA 18411

Lackawanna County (570) 587-7817

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 Haitham Abughnia's NPI number?

The NPI number for Haitham Abughnia is 1437346889. It was assigned to this individual provider in the NPPES registry on October 1, 2007.

Where is Haitham Abughnia located?

Haitham Abughnia practices at 401 N State St, Clarks Summit, PA 18411. The listed phone number is (570) 587-7817.

What is Haitham Abughnia's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Haitham Abughnia enrolled in Medicare?

Yes. Haitham Abughnia 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.

What insurance does Haitham Abughnia accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Haitham Abughnia 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.

Is Haitham Abughnia affiliated with any hospitals?

According to CMS data, Haitham Abughnia is affiliated with Geisinger-Community Medical Center, Wayne Memorial Hospital, Regional Hospital Of Scranton, Geisinger Wyoming Valley Medical Center and Barnes-Kasson County Hospital.

When was this NPI record last updated?

The NPPES record for Haitham Abughnia was last updated on November 8, 2023. 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.