Individual provider Active NPI

Abraham El-Sedfy, M.D.

  • Colon & Rectal Surgery Physician
  • Carbondale, IL
National Provider Identifier
1346506607
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
036.146496 Issued in IL
Practice address
305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone
(618) 457-3006
Fax
(618) 457-3008
NPI assigned
Apr 11, 2012
Last updated
Jan 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036146496 IL
Surgery Physician 208600000X NONE NJ
Colon & Rectal Surgery Physician 208C00000X 036.146496 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 206
Carbondale, IL 62901-1474

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 351-7300

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aelsedfy25556@sih.direct-ci.com
Direct Messaging Address aelsedfy25556@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NJ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180719001756 IL Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 6507113743 Reassigns benefits to 1 organization
I20230406002477 NJ Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 6507113743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

220 Hamburg Tpke
Wayne, NJ 07470-2110
Phone (973) 942-0040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy12
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NONENJMDDentist
036146496ILMDSurgery Physician
036.146496ILMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC CurrentSince Jan 3, 2023 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Aug 1, 2018 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations

1239 E Main St
Carbondale, IL 62901

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

305 W Jackson St
Ste 300
Carbondale, IL 62901
Phone (618) 457-3006

405 W Jackson St
Carbondale, IL 62901

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

225 Minnisink Rd
#102
Totowa, NJ 07512
Phone (862) 657-3100

220 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 790-8090

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

Organizations & group practices 3

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 1

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1346506607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 206",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-351-7300",
            "fax_number": "618-457-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EL-SEDFY",
        "first_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036146496",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "NONE",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036.146496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aelsedfy25556@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aelsedfy25556@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.