Individual provider Active NPI

Mahmoud Fenire, MD

  • Infectious Disease Physician
  • Buffalo, NY
National Provider Identifier
1124308325
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
01076920A Issued in IN
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 558-7597
NPI assigned
Aug 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X 01076920A IN Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

100 High St
Buffalo, NY 14203-1126
Phone (716) 558-7597

Other identifiers 1

IdentifierTypeStateIssuer
201376700MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170222002352 NY Practitioner - Internal MedicinePractitioner - Infectious Disease 0749574390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Academic Medicine Services, Inc.Group PAC ID 0941105241, 115 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01076920AINMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Academic Medicine Services, Inc. CurrentSince Mar 1, 2017 Accepting new patients
Kaleida Health Past Accepting new patients

Locations

462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

4498 Main St
Ste 23
Buffalo, NY 14226

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Organizations & group practices 2

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 6

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1124308325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-558-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-558-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENIRE",
        "first_name": "MAHMOUD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01076920A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201376700",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.