Individual provider Active NPI

Khalid Gamal Aboul-Nasr, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tucson, AZ
National Provider Identifier
1235579293
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
53563 Issued in AZ
Practice address
350 N Wilmot Rd
Tucson, AZ 85711
Phone
(602) 685-5211
Fax
(602) 685-5325
NPI assigned
Jul 4, 2013
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 53563 AZ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 53563 AZ Primary

Addresses

Primary practice location

350 N Wilmot Rd
Tucson, AZ 85711

Mailing address

1255 W Washington St
Tempe, AZ 85281-1210
Phone (602) 685-5211

Other practice location 1

1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone (520) 626-6830

Other identifiers 2

IdentifierTypeStateIssuer
458765MedicaidAZ
53563OtherAZARIZONA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190104001454 AZ Practitioner - Pathology 5597001065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Specialist of Arizona, LLPGroup PAC ID 4789583188, 69 clinicians

Practice addresses (Care Compare)

1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone (602) 685-5211

350 N Wilmot Rd
Tucson, AZ 85711-2602
Phone (602) 685-5211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.75 of 100Reported as group
Quality
75
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53563AZMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Specialist of Arizona, LLP Anatomic Pathology & Clinical Pathology CurrentSince Sep 19, 2018 Accepting new patients
Tucson Pathology Associates P.C. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1255 W Washington St
Tempe, AZ 85288
Phone 602685521145166

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

7350 E Speedway Blvd
Ste 101
Tucson, AZ 85710
Phone (520) 396-4757

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1235579293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W WASHINGTON ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852811210",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85711",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857240001",
            "country_code": "US",
            "telephone_number": "520-626-6830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABOUL-NASR",
        "first_name": "KHALID",
        "middle_name": "GAMAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "AZ",
            "license": "53563",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "53563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "458765",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL LICENSE",
            "identifier": "53563",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.