Individual provider Active NPI

Ahmed M El-Sabbagh, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1376917781
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
4301104848 Issued in MI
Practice address
1402 S Grand Blvd
Division of Nuclear Medicine, FDT-2
Saint Louis, MO 63104-1004
Phone
(314) 577-8047
NPI assigned
Nov 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Imaging & Therapy Physician 207UN0902X 2015018271 MO
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 4301104848 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301104848 MI Primary

Addresses

Primary practice location

1402 S Grand Blvd
Division of Nuclear Medicine, FDT-2
Saint Louis, MO 63104-1004

Mailing address

1402 S Grand Blvd
Division of Nuclear Medicine, FDT-2
Saint Louis, MO 63104-1004
Phone (314) 577-8047

Other identifiers 2

IdentifierTypeStateIssuer
2015018271OtherMOMISSOURI LICCENSE
4301104848OtherMIPHYSICIAN LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 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
I20170224000488 MI Practitioner - Geriatric MedicinePractitioner - Diagnostic Radiology 0941502488 Reassigns benefits to 11 organizations
I20250912000124 WI Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 0941502488 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians
Basha Diagnostics P CGroup PAC ID 5890681746, 28 clinicians

Practice addresses (Care Compare)

1 Wiliam Carls Dr
Commerce Township, MI 48382-2201
Phone (248) 937-5045

1096 S Belsay Rd
Suite J
Burton, MI 48509-1948
Phone (810) 715-0803

13365 Victoria Ave
Huntington Woods, MI 48070-1720
Phone (906) 449-3000

30701 Woodward Ave
Suite LL
Royal Oak, MI 48073-0988
Phone (248) 288-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015018271MOMDNuclear Imaging & Therapy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Savior Healthcare, Inc. Multi-Specialty CurrentSince Sep 24, 2025 Accepting new patients
Eastpointe Radiologists, PC Multi-Specialty Current Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Sep 24, 2025 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. Multi-Specialty Current Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. Multi-Specialty CurrentSince Sep 24, 2025 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Multi-Specialty Current Accepting new patients
Henry Ford Medical Group Genesys Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Sep 24, 2025 Accepting new patients
VHS Physicians of Michigan Multi-Specialty CurrentSince Dec 7, 2023 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Sep 24, 2025 Accepting new patients
Imaging Associates of Michigan PLLC Multi-Specialty CurrentSince Dec 1, 2024 Accepting new patients
Henry Ford Medical Group Genesys Multi-Specialty Current Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin Multi-Specialty CurrentSince Sep 24, 2025 Accepting new patients
SHPS, PLLC Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Prime Radiology Consultants P.C. Multi-Specialty CurrentSince Mar 17, 2025 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. Multi-Specialty CurrentSince Sep 24, 2025 Accepting new patients
Basha Diagnostics P C Multi-Specialty CurrentSince Aug 1, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Sep 24, 2025 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Sep 24, 2025 Accepting new patients
Henry Ford Medical Group Genesys Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Eastpointe Radiologists, P.C. Multi-Specialty CurrentSince Dec 11, 2024 Accepting new patients
Art of Radiology Imaging Associates, PLLC Multi-Specialty CurrentSince Mar 1, 2022 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Multi-Specialty Current Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Multi-Specialty CurrentSince Sep 24, 2025 Accepting new patients
Radiology Associates of Canton, Inc. Multi-Specialty Past Accepting new patients
Genesys Integrated Group Practice PC Multi-Specialty Past Accepting new patients

Locations (25 of 32)

29980 Network Pl
Chicago, IL 60673

9900 Birch Run Rd
Birch Run, MI 48415
Phone (989) 624-1500

1600 Brady St
Chesaning, MI 48616
Phone (989) 497-9395

51307 Gratiot Ave
Chesterfield, MI 48051
Phone (586) 741-3772

4154 W Vienna Rd
Clio, MI 48420
Phone (810) 686-3747

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

1096 S Belsay Rd
Ste J
Flint, MI 48509
Phone (810) 715-0803

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

5939 N Huron Rd
Oscoda, MI 48750
Phone (989) 739-1147

30701 Woodward Ave
Ste Ll
Royal Oak, MI 48073
Phone (248) 288-1600

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000

805 W Cedar St
Standish, MI 48658
Phone (989) 846-3500

200 Hemlock St
Tawas City, MI 48763
Phone (989) 362-0153

110 Beech St
Ste B
Tawas City, MI 48763
Phone (989) 362-1015

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

Organizations & group practices 27

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.

View all 27

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": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1376917781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "address_2": "DIVISION OF NUCLEAR MEDICINE, FDT-2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-577-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "address_2": "DIVISION OF NUCLEAR MEDICINE, FDT-2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-577-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-SABBAGH",
        "first_name": "AHMED",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-23",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "MO",
            "license": "2015018271",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301104848",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301104848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICCENSE",
            "identifier": "2015018271",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENCE",
            "identifier": "4301104848",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.