Individual provider Active NPI

Mahmoud O Jawhar, MD

  • Surgery Physician
  • Galax, VA
National Provider Identifier
1124094875
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101-231348 Issued in VA
Practice address
225 Hospital Dr
Galax, VA 24333-2228
Phone
(276) 236-6906
Fax
(276) 236-7179
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101-231348 VA Primary

Addresses

Primary practice location

225 Hospital Dr
Galax, VA 24333-2228

Mailing address

PO Box 1337
Galax, VA 24333-1337
Phone (276) 236-3210

Other identifiers 3

IdentifierTypeStateIssuer
7306245MedicaidVA
010360609MedicaidVA
007306245MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040907001086 VA Practitioner - General Surgery 9436125887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Eastern Virginia Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

101 Harris Rd
Kilmarnock, VA 22482-3880

1510 N 28TH St
Richmond, VA 23223-5311

95 Harris Rd
Kilmarnock, VA 22482-3845
Phone (804) 432-1608

Hospital & facility affiliations

  • Rappahannock General Hospital Hospital, Kilmarnock, VA, CCN 491308

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy111
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux15
Melanoma (skin cancer) excision32
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-231348VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC Surgery CurrentSince Jan 1, 2020 Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients
Twin County Family Care Centers Inc Past Accepting new patients

Locations

95 Harris Rd
Bldg 5
Kilmarnock, VA 22482
Phone (804) 435-3146

95 Harris Rd
Kilmarnock, VA 22482
Phone (804) 435-0023

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Organizations & group practices 4

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1124094875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243331337",
            "telephone_number": "276-236-3210",
            "fax_number": "276-236-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HOSPITAL DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332228",
            "telephone_number": "276-236-6906",
            "fax_number": "276-236-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWHAR",
        "first_name": "MAHMOUD",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101-231348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7306245",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010360609",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007306245",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.