Organization Active NPI

Amir Fahmy MD PA

  • Internal Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1083882328
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0076114 Issued in FL
Legal business name
AMIR FAHMY MD PA
Practice address
3345 Burns Rd
Ste#204
Palm Beach Gardens, FL 33410-4324
Phone
(561) 622-7604
Fax
(561) 622-7542
NPI assigned
Feb 20, 2008
Last updated
Nov 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Amir Fahmy, MDNPI 1912998436
Title
Physician
Phone
(561) 622-7604

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0076114 FL Primary

Addresses

Primary practice location

3345 Burns Rd
Ste#204
Palm Beach Gardens, FL 33410-4324

Mailing address

3345 Burns Rd
Ste#204
Palm Beach Gardens, FL 33410-4324
Phone (561) 622-7604

Other identifiers 2

IdentifierTypeStateIssuer
1912998436OtherFLINDIVIDUAL NPI
265237400MedicaidFL

Other names 1

  • FAMILY MEDICAL CENTER Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120612000046 FL Part B Supplier - Clinic/Group Practice 7315101904 Receives reassigned benefits from 3 practitioners
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1083882328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD",
            "address_2": "STE#204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104324",
            "telephone_number": "561-622-7604",
            "fax_number": "561-622-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD",
            "address_2": "STE#204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104324",
            "telephone_number": "561-622-7604",
            "fax_number": "561-622-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIR FAHMY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "FAHMY",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "561-622-7604",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0076114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1912998436",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265237400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY MEDICAL CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.