Individual provider Active NPI

Mahmoud Salem

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1023403797
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
289994 Issued in NY
Practice address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone
(718) 250-8000
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 289994 NY Primary

Addresses

Primary practice location

121 Dekalb Ave
Brooklyn, NY 11201-5425

Mailing address

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180608000770 NY Practitioner - Internal Medicine 6204181597 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

68 Graham Ave
Brooklyn, NY 11206-4017
Phone (646) 604-8130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
289994NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC CurrentSince Jun 5, 2023 Accepting new patients
Modern Physician Services PC Multi-Specialty CurrentSince Feb 2, 2025 Accepting new patients
Urban Care Walk in Medical Care PLLC Multi-Specialty CurrentSince Jan 2, 2024 Accepting new patients
SBH Physicians, PC Multi-Specialty CurrentSince Jun 5, 2023 Accepting new patients
Quarry Road Emergency Services P.C. Multi-Specialty Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

4507 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

263 Utica Ave
Brooklyn, NY 11213
Phone (646) 604-8110

436 Utica Ave
Brooklyn, NY 11213
Phone (646) 604-8150

445 77th St
Brooklyn, NY 11209
Phone (718) 238-4488

1248 Fulton St
Brooklyn, NY 11216
Phone (646) 604-8130

68 Graham Ave
Brooklyn, NY 11206
Phone (646) 604-8120

1169 Liberty Ave
Brooklyn, NY 11208
Phone (646) 604-8180

916 Flatbush Ave
Brooklyn, NY 11226
Phone (646) 604-8140

3733 82nd St
Jackson Hts, NY 11372
Phone (646) 604-8190

85 Broad St
Fl 18
New York, NY 10004
Phone (617) 750-2464

10342 Lefferts Blvd
South Richmond Hill, NY 11419
Phone (929) 468-9930

8922 Jamaica Ave
Woodhaven, NY 11421
Phone (646) 604-8170

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHFABD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1023403797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEM",
        "first_name": "MAHMOUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "289994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.