Individual provider Active NPI

Syed Khalid Mahmood, M.D

  • Hematology & Oncology Physician
  • Panama City, FL
National Provider Identifier
1174510184
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME42192 Issued in FL
Practice address
2614 Jenks Ave
Panama City, FL 32405-4311
Phone
(850) 769-2996
Fax
(850) 769-4665
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME42192 FL Primary

Addresses

Primary practice location

2614 Jenks Ave
Panama City, FL 32405-4311

Mailing address

2614 Jenks Ave
Panama City, FL 32405-4311
Phone (850) 769-2996

Other identifiers 1

IdentifierTypeStateIssuer
067617900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1174510184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054311",
            "telephone_number": "850-769-2996",
            "fax_number": "850-769-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054311",
            "telephone_number": "850-769-2996",
            "fax_number": "850-769-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "SYED",
        "middle_name": "KHALID",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME42192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067617900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.