Active NPI
Muhanad Ahmed Omran Bensaleem, MD,
- Pediatrics Physician
- Festus, MO
National Provider Identifier
1043848559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2024025980
- Practice address
- 1390 US Highway 61 Ste 2200N
Festus, MO 63028-4121 - Phone
- (314) 467-3800
- NPI assigned
- Mar 30, 2020
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2024025980 | MO | Primary |
Addresses
Primary practice location
1390 US Highway 61 Ste 2200N
Festus, MO 63028-4121
Mailing address
PO Box 776084
Chicago, IL 60677-7939
Phone (314) 467-3800
Other practice location 1
1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 590-1800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240805001439 | MO | Order and Referring Only - Pediatric Medicine | 4385181676 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024025980 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospitals East Communities | Past | Accepting new patients | |
| Mercy Clinic East Communities | Pediatrics | 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.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1043848559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776084",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606777939",
"telephone_number": "314-467-3800",
"fax_number": "636-933-8750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 US HIGHWAY 61 STE 2200N",
"city": "FESTUS",
"state": "MO",
"postal_code": "630284121",
"telephone_number": "314-467-3800"
}
],
"practiceLocations": [
{
"address_1": "1650 Grand Concourse",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104577606",
"country_code": "US",
"telephone_number": "718-590-1800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENSALEEM",
"first_name": "MUHANAD AHMED OMRAN",
"credential": "MD,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-30",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2024025980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Festus, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.