Individual provider Active NPI

Abdellatif H Abdelwahab, M.D

  • Neonatal-Perinatal Medicine Physician
  • Orlando, FL
National Provider Identifier
1326236407
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
ME98562 Issued in FL
Practice address
13535 Nemours Pkwy
Orlando, FL 32827-7402
Phone
(407) 567-4000
Fax
(407) 567-5924
NPI assigned
Oct 14, 2007
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 4301084809 MI
Neonatal-Perinatal Medicine Physician 2080N0001X ME98562 FL Primary
Neonatal-Perinatal Medicine Physician 2080N0001X C1-0013597 DE

Addresses

Primary practice location

13535 Nemours Pkwy
Orlando, FL 32827-7402

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4127

Other practice location 1

1215 E Michigan Ave
Sparrow Hospital-Neonatology Department
Lansing, MI 48912-1811
Phone (517) 364-2670

Other practice location 2

1215 E Michigan Ave
Sparrow Hospital-Neonatology Department
Lansing, MI 48912-1811
Phone (517) 364-2670

Other practice location 3

1600 Rockland Rd
Wilmington, DE 19803-3607
Phone (302) 651-4200

Other identifiers 1

IdentifierTypeStateIssuer
000066600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, DE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180206000738 FL Practitioner - Pediatric Medicine 6608014584 Reassigns benefits to 1 organization
I20200310000534 NJ Practitioner - Pediatric Medicine 6608014584 Reassigns benefits to 2 organizations
I20200616000794 DE Practitioner - Pediatric Medicine 6608014584 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0013597DEMDNeonatal-Perinatal Medicine Physician
ME98562FLMDNeonatal-Perinatal Medicine Physician
4301084809MIMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Dec 12, 2017 Accepting new patients
Nemours New Jersey Physician Practice, P.C. CurrentSince Dec 1, 2020 Accepting new patients
The Nemours Foundation CurrentSince Jun 2, 2020 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Dec 12, 2017 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401

Interoperability endpoints

  • Direct secure messaging: aabdelwahab189344@ahs.direct-ci.com

Organizations & group practices 7

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": "1192320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1326236407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4127",
            "fax_number": "904-697-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277402",
            "telephone_number": "407-567-4000",
            "fax_number": "407-567-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_2": "Sparrow Hospital-Neonatology Department",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121811",
            "country_code": "US",
            "telephone_number": "517-364-2670",
            "fax_number": "517-364-3994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 E Michigan Ave",
            "address_2": "Sparrow Hospital-Neonatology Department",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121811",
            "country_code": "US",
            "telephone_number": "517-364-2670",
            "fax_number": "517-364-3994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Rockland Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033607",
            "country_code": "US",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-4945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDELWAHAB",
        "first_name": "ABDELLATIF",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-14",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MI",
            "license": "4301084809",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME98562",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "DE",
            "license": "C1-0013597",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000066600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.