Individual provider Active NPI

Omar Metwally, MD

  • Internal Medicine Physician
  • Ketchikan, AK
National Provider Identifier
1104243336
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
226166 Issued in AK
Practice address
3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone
(907) 228-8300
NPI assigned
Mar 26, 2014
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Michigan State University College of Human Medicine, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Nabil Metwally MD PC 5 clinicians

Practice addresses (Care Compare)

24224 Joy Rd
Suite 101
Redford, MI 48239-1215
Phone (313) 565-6663

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, AK2 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
I20190607001906 MI Practitioner - HospitalistPractitioner - Internal Medicine 6305114083 Reassigns benefits to 1 organization
I20251001001644 AK Practitioner - Internal Medicine 6305114083 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138074CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Peacehealth Current Accepting new patients
Nabil Metwally MD PC Internal Medicine CurrentSince May 13, 2019 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104

24224 Joy Rd
Ste 101
Redford, MI 48239
Phone (248) 305-6154

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 138074 CA
Internal Medicine Physician 207R00000X 226166 AK Primary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301114008 MI

Addresses

NPPES NPI Registry

Primary practice location

3100 Tongass Ave
Ketchikan, AK 99901-5746

Mailing address

24224 Joy Rd
Ste 101
Redford, MI 48239-1215
Phone (510) 437-4141

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
138074OtherCACA LICENSE
4301114008OtherMIMI LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 17, 2025.

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1104243336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24224 JOY RD",
            "address_2": "STE 101",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391215",
            "telephone_number": "510-437-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015746",
            "telephone_number": "907-228-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METWALLY",
        "first_name": "OMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "138074",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "226166",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301114008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "138074",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4301114008",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

Verify at the official NPI Registry.