Individual provider Active NPI

Nabila Adham Elbadawi, MD,PHD

  • Specialist
  • Syracuse, NY
National Provider Identifier
1073559530
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
133848-1 Issued in NY
Practice address
815 James St
Syracuse, NY 13203-2504
Phone
(315) 329-7520
Fax
(315) 329-7505
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 133848-1 NY Primary

Addresses

Primary practice location

815 James St
Syracuse, NY 13203-2504

Mailing address

815 James St
Syracuse, NY 13203-2504
Phone (315) 329-7520

Other identifiers 1

IdentifierTypeStateIssuer
00699601MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
133848-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical Radiotherapy, P.C. PastSince Jan 1, 2008 Accepting new patients
Upstate University Radiation Oncology, Inc. Past Accepting new patients
Radiotherapy Associates of Auburn PC PastSince Nov 19, 2007 Accepting new patients

Organizations & group practices 3

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1073559530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032504",
            "telephone_number": "315-329-7520",
            "fax_number": "315-329-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032504",
            "telephone_number": "315-329-7520",
            "fax_number": "315-329-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBADAWI",
        "first_name": "NABILA",
        "middle_name": "ADHAM",
        "name_prefix": "Dr.",
        "credential": "MD,PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "133848-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00699601",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.