Active NPI
Amr Abdelghany Khalafallah, MD
- Psychiatry Physician
- Hanover, PA
National Provider Identifier
1013018308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 28568
- Practice address
- 1150 Carlisle St
Hanover, PA 17331-1100 - Phone
- (717) 632-4900
- Fax
- (717) 632-4313
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 28568 | SC | Primary |
| Psychiatry Physician | 2084P0800X | MD060096L | PA |
Addresses
Primary practice location
1150 Carlisle St
Hanover, PA 17331-1100
Mailing address
2319 Saint Matthews Rd
Orangeburg, SC 29118-2042
Phone (803) 536-1571
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016673100003 | Medicaid | PA | |
| 327877 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD060096L | PA | MD | Psychiatry Physician |
| 28568 | SC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Truenorth Wellness Services | Past | Accepting new patients | |
| Family Care for Children & Youth, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Illness Community Based Residential Treatment Facility
- York, PA
- NPI 1689740839
-
- Community/Behavioral Health Agency
- Hanover, PA
- NPI 1912013509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1013018308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2319 SAINT MATTHEWS RD",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291182042",
"telephone_number": "803-536-1571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 CARLISLE ST",
"city": "HANOVER",
"state": "PA",
"postal_code": "173311100",
"telephone_number": "717-632-4900",
"fax_number": "717-632-4313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALAFALLAH",
"first_name": "AMR",
"middle_name": "ABDELGHANY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "28568",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD060096L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016673100003",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "327877",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hanover, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.