Ahmad Mahmoud Alkashash
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Boston, MA
NPI 1053930487 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1053930487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 1018736 (MA)
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 726-6716
- NPI assigned
- Apr 15, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Indiana University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ameripath Indianapolis PC
Practice addresses (Care Compare)
2560 N Shadeland Ave
Suite a
Indianapolis, IN 46219-1706
Phone (317) 275-8072
Hospital & facility affiliations
- Ascension St Vincent Hospital
- Community Hospital North
- Ascension St Vincent Carmel
- Ascension St Vincent Anderson
- Community Hospital South, Inc.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240709004083 | MA | Practitioner - Pathology | 0244655991 | Reassigns benefits to 2 organizations |
| I20250618001714 | IN | Practitioner - Pathology | 0244655991 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1018736 | MA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Anatomic Pathology & Clinical Pathology | Current |
Accepting new patients |
| Ameripath Indianapolis PC | Anatomic Pathology & Clinical Pathology | Current |
Accepting new patients |
| Ameripath Indianapolis PC | Anatomic Pathology & Clinical Pathology | Current |
Accepting new patients |
| The General Hospital Corporation | Current |
Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Locations
13179 Collection Ctr Dr
Chicago, IL 60693
2560 N Shadeland Ave
Ste A
Indianapolis, IN 46219
Phone (317) 275-8000
2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617
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) 724-4260
14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 1018736 | MA | Yes |
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
Other providers in Boston, MA
- Roaa Abdullatif Aljuaid
- Riyam Aljuboori
- Baraa Jassim Mohammed Aljumaly
- Nada Saleh Alkaki
- Abdalla Alkandari
- Mohammad Sami Alkathiri
- Michael Alkhalil
- Turki Salah Alkhallagi
- Hadeel Sullman Alkhamis
- Maan Sulaiman a Alkharashi
All providers in Boston, MA · Anatomic Pathology & Clinical Pathology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.