Individual provider Active NPI

Ahmed Diab, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1063197739
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2023021902 Issued in MO
Practice address
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone
(314) 454-8087
NPI assigned
Jun 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2023021902 MO Primary

Addresses

Primary practice location

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave, CB 8121
Saint Louis, MO 63110

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529002867 MO Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology) 4486124583

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023021902MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc PastSince Jun 25, 2023 Accepting new patients

Organizations & group practices 1

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1063197739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE, CB 8121",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEW HOSP PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-454-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAB",
        "first_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2023021902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.