Individual provider Active NPI

Ahmad Mahmoud Alkashash

  • Anatomic Pathology & Clinical Pathology Physician
  • Boston, MA
National Provider Identifier
1053930487
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
1018736 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-6716
NPI assigned
Apr 15, 2020
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 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
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 1018736 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

350 W 11TH St RM 4083
Indianapolis, IN 46202-4108
Phone (317) 274-2476

Other practice location 1

350 W 11th St Rm 4083
Indianapolis, IN 46202-4108
Phone (317) 274-2476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20240709004083 MA Practitioner - Pathology 0244655991 Reassigns benefits to 2 organizations
I20250618001714 IN Practitioner - Pathology 0244655991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ameripath Indianapolis PCGroup PAC ID 2961475058, 35 clinicians

Practice addresses (Care Compare)

2560 N Shadeland Ave
Suite a
Indianapolis, IN 46219-1706
Phone (317) 275-8072

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1018736MAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 2, 2024 Accepting new patients
Ameripath Indianapolis PC Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc Anatomic Pathology & Clinical Pathology CurrentSince Jul 2, 2024 Accepting new patients
Ameripath Indianapolis PC Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2025 Accepting new patients
Major Hospital Past Accepting new patients

Locations

13179 Collection Ctr Dr
Chicago, IL 60693

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

2560 N Shadeland Ave
Ste A
Indianapolis, IN 46219
Phone (317) 275-8072

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

62 13th St
Charlestown, MA 02129
Phone (617) 724-3874

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1053930487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 11TH ST RM 4083",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024108",
            "telephone_number": "317-274-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-6716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 W 11th St Rm 4083",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462024108",
            "country_code": "US",
            "telephone_number": "317-274-2476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALKASHASH",
        "first_name": "AHMAD",
        "middle_name": "MAHMOUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "1018736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.