Individual provider Active NPI

Radowan Ali Mahgoub Elnair, MD

  • Hematology (Internal Medicine) Physician
  • Providence, RI
National Provider Identifier
1124479811
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
MD19360 Issued in RI
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-6565
NPI assigned
Jun 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD19360 RI
Hematology (Internal Medicine) Physician 207RH0000X MD19360 RI Primary

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

200 1St St SW
Rochester, MN 55905-0002
Phone (507) 284-2511

Other practice location 1

50 Maude St
Providence, RI 02908-4325
Phone (401) 456-2077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, AZ2 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
I20230724000751 RI Practitioner - Hematology/Oncology 6204123961 Reassigns benefits to 2 organizations
I20260603000910 AZ Practitioner - Hematology 6204123961

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect Chartercare RWMC, LLC 66 clinicians

Practice addresses (Care Compare)

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000

Hospital & facility affiliations

  • Roger Williams Medical Center Hospital, Providence, RI, CCN 410004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19360RIMDHematology & Oncology Physician
0336SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare RWMC, LLC CurrentSince Jul 17, 2023 Accepting new patients
Prospect Chartercare RWMC, LLC Hematology & Oncology CurrentSince Jul 17, 2023 Accepting new patients
Chartercare Roger Williams Medical Center Hematology & Oncology CurrentSince May 28, 2025 Accepting new patients

Locations

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

50 Maude St
Providence, RI 02908
Phone (401) 456-2200

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 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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1124479811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050002",
            "telephone_number": "507-284-2511",
            "fax_number": "507-266-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-6565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Maude St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084325",
            "country_code": "US",
            "telephone_number": "401-456-2077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELNAIR",
        "first_name": "RADOWAN",
        "middle_name": "ALI MAHGOUB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "RI",
            "license": "MD19360",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "RI",
            "license": "MD19360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.