Mohamed Moneeb Abdellatif Azab, M.D

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

75068-20 Issued in WI

Practice address

1726 Shawano Ave
Green Bay, WI 54303-3216

Phone

(920) 496-4700

NPI assigned

Jul 2, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Norman Regional Providers Specialty CareGroup PAC ID 5496900706, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Norman Regional Hospital, Norman, OK, CCN 370008

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

90.91 of 100Reported as apm

Quality

76.55

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mazab131566@direct.llu.edu
• Direct secure messaging: mohamed.azab@nrh.eclinicaldirectplus.com

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.

• Norman Regional Providers Specialty Care

  • Surgery Physician
  • Norman, OK
  • NPI 1548513773
  Medicare reassignment Care Compare group NPD
• Norman Regional Hospital Authority

  • General Acute Care Hospital
  • Norman, OK
  • NPI 1700882578
  NPD (past)
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Norman Regional Hospital Authority

  • General Acute Care Hospital
  • Norman, OK
  • NPI 1700882578
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1013390434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 W Charleston Blvd",
            "address_2": "Suite 230",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022325",
            "country_code": "US",
            "telephone_number": "702-671-2358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZAB",
        "first_name": "MOHAMED",
        "middle_name": "MONEEB ABDELLATIF",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "75068-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin M Auten
• Michael Thomas Avery, DO
• Aviva Medical
• John Tokunbo Awowale, M.D.
• Angela Ayala, LPC
• Craig Babiarz, C.R.N.A.
• Lukasz S Babiarz, M.D., M.B.A.
• Britny L Babler, APNP
• Haley Babler, LAT, ATC
• Bach and Boone LLC

• Gastroenterology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Gastroenterology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.