Amgad Ghoprial

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Baltimore, MD

NPI 1194428813 · NPPES record last updated Mar 22, 2023

Key facts

NPI
1194428813
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
22 S Greene St RM N3E09
Baltimore, MD 21201-1544
Phone
(410) 328-6110
NPI assigned
Mar 22, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231127000350 MD Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
6002264421

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

22 S Greene St RM N3E09
Baltimore, MD 21201-1544

Mailing address

22 S Greene St RM N3E09
Baltimore, MD 21201-1544
Phone (410) 328-6110

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 22, 2023.

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1194428813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOPRIAL",
        "first_name": "AMGAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

All providers in Baltimore, MD · Student in an Organized Health Care Education/Training Program in Maryland

Sources for this page

Verify at the official NPI Registry.