Individual provider Active NPI

Ahmed Abou Elmagd, MD

  • Internal Medicine Physician
  • Fort Sill, OK
National Provider Identifier
1205920717
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12434 Issued in PR
Practice address
4303 Pitman
Fort Sill, OK 73503
Phone
(580) 585-5600
Fax
(580) 585-5703
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12434 PR Primary

Addresses

Primary practice location

4303 Pitman
Fort Sill, OK 73503

Mailing address

# 4 Pecan Valley Dr.
Lawton, OK 73505
Phone (580) 284-3231

Other identifiers 1

IdentifierTypeStateIssuer
200063250AMedicaidOK

Other names 1

  • Ahmed Abd Elmonsef Abou-Elmagd Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150120000420 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3274713177

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1205920717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "# 4 PECAN VALLEY DR.",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-284-3231",
            "fax_number": "580-585-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 PITMAN",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "73503",
            "telephone_number": "580-585-5600",
            "fax_number": "580-585-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU ELMAGD",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200063250A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AHMED",
            "last_name": "ABOU-ELMAGD",
            "middle_name": "ABD ELMONSEF",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Sill, OK

Sources for this page

Verify at the official NPI Registry.