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Dr. Abbas A Chamsuddin

Diagnostic Radiology St Lucie Medical Center NPI1578539557
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Summary

About

Dr. Abbas A Chamsuddin specialises in Diagnostic Radiology. He currently works at St Lucie Medical Center in Georgia and has affiliate with 4 other institutions.

Provider Details

NPI Number 1578539557
Provider Name Abbas A Chamsuddin
Credential MD
Specialization Diagnostic Radiology
Medical School Name Other
Graduation Year 1991
Gender M
Entity Type Individual
PAC ID by PECOS 0446150262
Professional Enrollment ID I20040621000923
Enumeration Date 02/28/2006
Last Update Date 06/20/2022

Contact Details

Business Practice address 1501 CLAIRMONT RD, Decatur,
30033-4601 Georgia View on Google Map
Business Practice phone 952-595-1100
Business Practice fax 612-294-4903
Mailing address 1501 CLAIRMONT RD, Decatur,
30033-4601 Georgia View on Google Map
Other phone 888-886-5238
Other fax 888-886-9330
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Abbas A Chamsuddin MD Update NPI

Payments

Total Payment Worth

$321.61
from 6 payments in the last 6 years

Total Cash or Cash Equivalent

$252.30
from 4 payments in the last 6 years

Total In-kind Items & Services

$69.31
from 2 payments in the last 6 years

Hospital Affilitation

St Lucie Medical Center in Decatur

Decatur, Georgia

Lawnwood Regional Medical Center & Heart Institute

Wilkes-Barre General Hospital

Sharon Regional Health System

Gulf Coast Regional Medical Center

Education & Training

Other

Diagnostic Radiology, 1991

Group Affiliation

Organization Name PECOS PAC ID Members
Radiology Associates Of Wyoming Valley Inc 2365355906 24
Vesta Telemedicine Solutions Pllc 9638585706 9
Bridgeport Radiological Associates Llc 0941291082 33
Radiology Group Llc 1254302573 16
Vesta Telemedicine Solutions Pc 2365850948 17
Rapid Radiology Inc 2062734858 49
Central Avenue Professional Services, Pc 7214258003 36
Lucien Diagnostic Imaging Inc 6305741307 12
Doctors Imaging Services Llc 3274546817 21
Radiology Group Of Abington Pc 5991780892 81
Jupiter Imaging Associates Inc 5294629135 42
Butler Imaging And Interventional Associates Llc 8426115478 28
Clhg-Acadian Llc 0840521209 22
Clhg-Ville Platte Llc 4486903309 28
Radiology Physician Solutions Of North Florida Llc 2466710306 70
Regional Imaging, Pc 7315349966 8
Shps Pllc 7315325933 16
Sheridan Radiology Services Of Central Florida Inc 4688762149 97
Suburban Medical Group Llc 6204145642 31
Radiology Associates Of Oxford - Pa 1052309424 19
Florida Radiology Imaging At Lake Mary, Llc 1254311137 165
Allegiance Hospital Of Many,Llc 3274607551 36
Sheridan Radiology Services Of South Florida Inc 7517000847 43
Rfc Radiology Associates Llc 8022141894 14
North Oaks Medical Center Llc 2466629522 186
Allen Parish Hospital District No 3 3274431341 9
Fands Radiology Pc 0244368868 133
Radiology Physician Solutions Of Florida Llc 3870716731 80
Rmed Llc 6608768411 22
Florida United Radiology Lc 9537156757 63
Regional Imaging Enm Llc 2264847128 10
Coastal Imaging Llc 8123312055 51
Vsi Rad Llc 9436457843 15
Elite Imaging Llc 2466496880 106
Tampa Bay Radiology Associates Pa 1456381136 157
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Provider Taxonomy Details

Provider Taxonomy 1
Speciality
Diagnostic Radiology Physician
Grouping name
Allopathic & Osteopathic Physicians
Taxonomy
2085R0202X
License No.
051028 (Georgia)
Primary Taxonomy
Speciality
Diagnostic Radiology Physician
Grouping name
Allopathic & Osteopathic Physicians
Taxonomy
2085R0202X
License No.
25MA06847000 (New Jersey)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1578539557
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Chamsuddin
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Abbas
The first name of the provider, if the provider is an individual.
Provider Credential Text M.D.
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address 1501 CLAIRMONT RD
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Decatur
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Georgia
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 30033-4601
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 888-886-5238
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 888-886-9330
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 1501 CLAIRMONT RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Decatur
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Georgia
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 30033-4601
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 952-595-1100
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 612-294-4903
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 02/28/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 06/20/2022
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 2085R0202X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Healthcare Provider Taxonomy #1
Provider License Number 1 051028
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 GA
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #2 2085R0202X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 2 A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Healthcare Provider Taxonomy #2
Provider License Number 2 25MA06847000
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2 NJ
Provider License Number State Code #2
Healthcare Provider Primary Taxonomy Switch 2 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
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