NPIMap

Organization Active NPI

Rise Medical Group, LLC

  • Pulmonary Disease Physician
  • Bowling Green, OH
National Provider Identifier
1285864488
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35084310 Issued in OH
Legal business name
RISE MEDICAL GROUP, LLC
Practice address
960 W Wooster St Ste 107
Bowling Green, OH 43402-2646
Phone
(419) 373-7692
NPI assigned
Jul 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Authorized official

Name
Hesham El Gamal, MDNPI 1285615245
Title
Owner
Phone
(617) 216-2945

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X 35084310 OH
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 35084310 OH Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X 35084310 OH

Addresses

Primary practice location

960 W Wooster St Ste 107
Bowling Green, OH 43402-2646

Mailing address

PO Box 72369
Cleveland, OH 44192-0002
Phone (419) 353-7069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091120000288 OH Part B Supplier - Clinic/Group Practice 9537208178 Receives reassigned benefits from 3 practitioners
Practice locations: Wauseon, OH; Toledo, OH; Perrysburg, OH; Sylvania, OH; Bowling Green, OH; Holland, OH; Maumee, OH

National Provider Directory

National Provider Directory

Locations

959 Illinois Ave
Maumee, OH 43537
Phone 85929148001185

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1285864488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72369",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441920002",
            "telephone_number": "419-353-7069",
            "fax_number": "419-353-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 W WOOSTER ST STE 107",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022646",
            "telephone_number": "419-373-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "EL GAMAL",
        "authorized_official_first_name": "HESHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-216-2945",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35084310",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35084310",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OH",
            "license": "35084310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.