Active NPI
Omar Metwally, MD
- Internal Medicine Physician
- Ketchikan, AK
National Provider Identifier
1104243336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 226166
- 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.
-
- General Acute Care Hospital
- Wayne, MI
- NPI 1295785285
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
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
- Hospitalist
- Education
- Michigan State University College of Human Medicine, 2013
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Nabil Metwally MD PC
Practice addresses (Care Compare)
24224 Joy Rd
Suite 101
Redford, MI 48239-1215
Phone (313) 565-6663
Hospital & facility affiliations
- Beaumont Hospital - Dearborn
- Corewell Health Wayne Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190607001906 | MI | Practitioner - Hospitalist | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 138074 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Internal Medicine | Current | Accepting new patients |
| Peacehealth | Current | Accepting new patients | |
| Nabil Metwally MD PC | Internal Medicine | Current | 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 138074 | Other | CA | CA LICENSE |
| 4301114008 | Other | MI | MI 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.