Khalid Gamal Aboul-Nasr, M.D.
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Tucson, AZ
NPI 1235579293 · NPPES record last updated Aug 4, 2020
Key facts
- NPI
- 1235579293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 53563 (AZ)
- Practice address
- 350 N Wilmot Rd
Tucson, AZ 85711 - Phone
- (602) 685-5211
- Fax
- (602) 685-5325
- NPI assigned
- Jul 4, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pathology Specialist of Arizona, LLP
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
- St Joseph'S Hospital
- Cobre Valley Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.75 of 100
- Quality
- 75
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190104001454 | AZ | Practitioner - Pathology | 5597001065 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53563 | AZ | MD | Cytopathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Specialist of Arizona, LLP | Anatomic Pathology & Clinical Pathology | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 53563 | AZ | Yes |
| Cytopathology Physician | 207ZC0500X | 53563 | AZ |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 458765 | Medicaid | AZ | |
| 53563 | Other | AZ | ARIZONA MEDICAL LICENSE |
Other providers in Tucson, AZ
- Phoebe Abney
- Sara Abolmolouk
- Sameer C Aboufadel
- Mohammad Rabeia Aboul-Jibin
- Ahmed Gamal Aboul-Nasr
- Goitom Haile Abraha
- Cheryl Louise Abraham
- Melvin Abraham
- Ryan Abraham
- William L Abraham
All providers in Tucson, AZ · Anatomic Pathology & Clinical Pathology Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.