Individual provider Active NPI

Ahmed Ghaleb, MD

  • Interventional Pain Medicine Physician
  • Little Rock, AR
National Provider Identifier
1104916675
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
E-3215 Issued in AR
Practice address
11220 Executive Center Dr Ste 200
Little Rock, AR 72211-4492
Phone
(501) 219-1114
Fax
(501) 219-1115
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-3215 AR
Pain Medicine (Anesthesiology) Physician 207LP2900X E-3215 AR
Interventional Pain Medicine Physician 208VP0014X E-3215 AR Primary

Addresses

Primary practice location

11220 Executive Center Dr Ste 200
Little Rock, AR 72211-4492

Mailing address

11220 Executive Center Dr Ste 200
Little Rock, AR 72211-4492
Phone (501) 219-1114

Other identifiers 3

IdentifierTypeStateIssuer
050086527OtherARRAILROAD MEDICARE
146584001MedicaidAR
P00020406OtherARRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20080606000596 AR Practitioner - AnesthesiologyPractitioner - Pain Management 3870663552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Spine and Pain Centers IncGroup PAC ID 0547494189, 3 clinicians

Practice addresses (Care Compare)

11220 Executive Ctr Dr
Suite 200
Little Rock, AR 72211-4492
Phone (501) 219-1114

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
34.28 of 100Reported as individual
Quality
25
Improvement activities
0
Cost
75.15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Associates, Inc Past Accepting new patients
Ozarks Medical Center Interventional Pain Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aghaleb@1494.securemail.prognocis.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1104916675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114492",
            "telephone_number": "501-219-1114",
            "fax_number": "501-219-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114492",
            "telephone_number": "501-219-1114",
            "fax_number": "501-219-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHALEB",
        "first_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-3215",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AR",
            "license": "E-3215",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E-3215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050086527",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146584001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00020406",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.