Active NPI
Mohamed Gomaa, PHARM D
- Pharmacist
- Pontiac, MI
National Provider Identifier
1043758246
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302045121
- Practice address
- 35 S Johnson St Ste 1E
Pontiac, MI 48341-1660 - Phone
- (248) 791-7566
- Fax
- (248) 791-7567
- NPI assigned
- Feb 8, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302045121 | MI | Primary |
Addresses
Primary practice location
35 S Johnson St Ste 1E
Pontiac, MI 48341-1660
Mailing address
35 S Johnson St Ste 1E
Pontiac, MI 48341-1660
Phone (248) 791-7566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205282266 | Medicaid | MI |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302045121 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512777600000",
"number": "1043758246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 S JOHNSON ST STE 1E",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411660",
"telephone_number": "248-791-7566",
"fax_number": "248-791-7567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 S JOHNSON ST STE 1E",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411660",
"telephone_number": "248-791-7566",
"fax_number": "248-791-7567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMAA",
"first_name": "MOHAMED",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-08",
"last_updated": "2017-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302045121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1205282266",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.