Individual provider Active NPI

Almuhannad Idris, M.D.

  • Internal Medicine Physician
  • Fall River, MA
National Provider Identifier
1366674707
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
250643 Issued in MA
Practice address
795 Middle St
Fall River, MA 02721-1733
Phone
(508) 235-5262
NPI assigned
Aug 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 250643 MA Primary
Internal Medicine Physician 207R00000X 4301093266 MI

Addresses

Primary practice location

795 Middle St
Fall River, MA 02721-1733

Mailing address

50 4TH St Apt 1
Providence, RI 02906-2832
Phone (248) 217-8266

Other practice location 1

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aidris54834@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000723 MA Practitioner - Internal MedicinePractitioner - Hospitalist 3971754581 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prima Care, PCGroup PAC ID 2567356017, 222 clinicians
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

277 Pleasant St
Suite 305
Fall River, MA 02721-3005
Phone (508) 672-6068

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

Hospital & facility affiliations

  • Hospice and Palliative Care Hospice, Fairhaven, MA, CCN 221536
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
  • Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
  • Southcoast Hospitals Group Inc. Inpatient rehabilitation facility, Fall River, MA, CCN 22T074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301093266MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2020 Accepting new patients
Prima Care, PC CurrentSince Mar 1, 2016 Accepting new patients
Prima Care, PC CurrentSince Mar 1, 2016 Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Ipc Hospitalists of New England PC Internal Medicine CurrentSince Sep 15, 2012 Accepting new patients
Ipc Hospitalists of New England, P.C. Internal Medicine CurrentSince Sep 15, 2012 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2020 Accepting new patients
Lifespan of Massachusetts - Fall River Inc Past Accepting new patients
Southcoast Hospitals Group, Inc Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

277 Pleasant St
Ste 305
Fall River, MA 02721
Phone (508) 672-1010

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

277 Pleasant St
Fall River, MA 02721
Phone (508) 617-9740

277 Pleasant St
Fl 4
Fall River, MA 02721
Phone 50867632921244

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

67 Union St
Natick, MA 01760
Phone (508) 383-1104

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Interoperability endpoints

  • Direct secure messaging: aidris54834@direct.southcoast.org

Organizations & group practices 10

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 5

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": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1366674707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 4TH ST APT 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062832",
            "telephone_number": "248-217-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 MIDDLE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027211733",
            "telephone_number": "508-235-5262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027203703",
            "country_code": "US",
            "telephone_number": "508-973-5919",
            "fax_number": "508-973-5916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDRIS",
        "first_name": "ALMUHANNAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-19",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "250643",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301093266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aidris54834@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.