Mahmoud Tayseer Agrama, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15519R Issued in LA

Practice address

200 Corporate Boulevard
Suite 201
Lafayette, LA 70508

Phone

(800) 893-9698

NPI assigned

Apr 7, 2006

Last updated

Aug 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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 Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)
• Emergency Associates of the North Ward, P.a.

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1235130238
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1376506816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1403",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705186151",
            "telephone_number": "337-577-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BOULEVARD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRAMA",
        "first_name": "MAHMOUD",
        "middle_name": "TAYSEER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "15519R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1468673",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oluwatoni Afolabi, M.D.
• Agape Therapeutic Solutions
• Ageless Independence Center Corp
• Sudhir K. Aggarwal, M.D.
• Peter N Agomuo, M.D
• Aguillard & Associates, LLC (EarlySteps Provider)
• Lauren Poche Aguillard
• Jatinder P Ahluwalia, M.D.
• Aimee Scelfo LCSW LLC
• Airway Home Medical Equipment Inc

• Internal Medicine Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.