NPIMap

Individual provider Active NPI

Azzam A Adhal, MD

  • Internal Medicine Physician
  • Panama City, FL
National Provider Identifier
1295714129
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME39261 Issued in FL
Practice address
2195 Jenks Ave
Ste B
Panama City, FL 32405-4551
Phone
(850) 784-6696
Fax
(850) 785-2100
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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 ME39261 FL Primary

Addresses

Primary practice location

2195 Jenks Ave
Ste B
Panama City, FL 32405-4551

Mailing address

PO Box 15909
Panama City, FL 32406-5909
Phone (850) 784-6696

Other identifiers 3

IdentifierTypeStateIssuer
066935100MedicaidFL
0080NOtherFLFLORIDA BLUE
1518360288OtherFLFLORIDA BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000200 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1951311596 Receives reassigned benefits from 1 practitioner
Practice locations: Panama City, FL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2195 Jenks Ave
Suite B
Panama City, FL 32405-4683
Phone (850) 784-6696

Hospital & facility affiliations

  • Tender Touch Health Care Services Home health agency, Panama City, FL, CCN 107791
  • Enhabit Home Health Home health agency, Panama City, FL, CCN 108380
  • Centerwell Home Health Home health agency, Panama City, FL, CCN 107275
  • NHC Homecare Home health agency, Panama City Beach, FL, CCN 107099
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • Pruitthealth - Panama City Nursing home, Panama City, FL, CCN 106121
  • St Andrews Bay Skilled Nursing and Rehabilitation Nursing home, Panama City, FL, CCN 105543
  • Community Health and Rehabilitation Center Nursing home, Panama City, FL, CCN 105975
  • Aviata at Emerald Shores Nursing home, Callaway, FL, CCN 105148

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME39261FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Azzam Adhal, M.D. Internal Medicine CurrentSince Jan 1, 1990 Accepting new patients

Locations

2195 Jenks Ave
Ste B
Panama City, FL 32405
Phone (850) 774-8484

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHGGBA/Endpoint/CHGGBA

Practitioners & affiliated clinicians

Practitioners 1

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

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1295714129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15909",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324065909",
            "telephone_number": "850-784-6696",
            "fax_number": "850-785-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE",
            "address_2": "STE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054551",
            "telephone_number": "850-784-6696",
            "fax_number": "850-785-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADHAL",
        "first_name": "AZZAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME39261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066935100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "0080N",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "1518360288",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.