Individual provider Active NPI

Ahmed Abo-Mahmood, DPM

  • Podiatrist
  • Manchester, MO
National Provider Identifier
1215425574
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2022048066 Issued in MO
Practice address
1209 Forest Pkwy Apt 103
Manchester, MO 63021-5579
Phone
(903) 821-8545
Fax
(314) 932-0877
NPI assigned
Apr 23, 2018
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2022048066 MO Primary

Addresses

Primary practice location

1209 Forest Pkwy Apt 103
Manchester, MO 63021-5579

Mailing address

1209 Forest Pkwy Apt 103
Manchester, MO 63021-5579
Phone (903) 821-8545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110001543 MO Practitioner - Podiatry 0840547576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

504 Thornlea CT
Ballwin, MO 63011-4406
Phone (903) 821-8545

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14
Removal of nail tissue1066
Removal or shaving of skin growth588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Healers Holdings - St. Louis, LLC Podiatrist CurrentSince Feb 1, 2023 Accepting new patients
Foot Healers Holdings - St. Louis, LLC Podiatrist CurrentSince Feb 1, 2023 Accepting new patients
A Foot Doctor LLC Podiatrist CurrentSince Oct 8, 2023 Accepting new patients

Locations

1726 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 777-4500

7257 Watson Rd
Saint Louis, MO 63119
Phone (314) 916-6286

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2451/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1215425574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 FOREST PKWY APT 103",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215579",
            "telephone_number": "903-821-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 FOREST PKWY APT 103",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215579",
            "telephone_number": "903-821-8545",
            "fax_number": "314-932-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABO-MAHMOOD",
        "first_name": "AHMED",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "2022048066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, MO

Sources for this page

Verify at the official NPI Registry.