Individual provider Active NPI

Sanaa Abdel-Rahman Mahmoud, M.D.

  • Allergy & Immunology Physician
  • Somerset, KY
National Provider Identifier
1174527956
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
39319 Issued in KY
Practice address
110 Hardin LN
Ste 3
Somerset, KY 42503-3818
Phone
(606) 451-0115
Fax
(606) 451-0155
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 39319 KY Primary

Addresses

Primary practice location

110 Hardin LN
Ste 3
Somerset, KY 42503-3818

Mailing address

110 Hardin LN
Ste 3
Somerset, KY 42503-3818
Phone (606) 451-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050311000093 KY Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 3274587761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 Hardin LN
Somerset, KY 42503-3818
Phone (606) 451-0115

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Asthma & Immunology Center, LLC Allergy & Immunology CurrentSince Feb 1, 2005 Accepting new patients

Locations

110 Hardin Ln
Ste 3
Somerset, KY 42503
Phone (606) 451-0115

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIDAAA/Endpoint/EIDAAA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1174527956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "address_2": "STE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-0115",
            "fax_number": "606-451-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "address_2": "STE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-0115",
            "fax_number": "606-451-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUD",
        "first_name": "SANAA",
        "middle_name": "ABDEL-RAHMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": "39319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.