Individual provider Active NPI

Kamaleldin Hassan Kamal, MD

  • Internal Medicine Physician
  • Biloxi, MS
National Provider Identifier
1396837795
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01057156A Issued in IN
Practice address
400 Veterans Ave
Biloxi, MS 39531-2410
Phone
(228) 523-4555
Fax
(228) 523-4515
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 239518 NY
Hospitalist Physician 208M00000X 239518 NY
Hospitalist Physician 208M00000X 01057156A IN
Internal Medicine Physician 207R00000X 01057156A IN Primary

Addresses

Primary practice location

400 Veterans Ave
Biloxi, MS 39531-2410

Mailing address

753 Classon Ave
#5L
Brooklyn, NY 11238-4647
Phone (646) 403-1976

Other practice location 1

2215 Burdett Avenue
Troy, NY 12180
Phone (518) 271-3300

Other identifiers 2

IdentifierTypeStateIssuer
000000754235OtherINANTHEM PROVIDER NUMBER
200899750MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 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
I20070614000751 NY Practitioner - Internal Medicine 9032215058 Reassigns benefits to 2 organizations
I20140215000078 TX Practitioner - Internal Medicine 9032215058 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Gallup Indian Medical Center CurrentSince Nov 27, 2013 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Jul 23, 2015 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Jul 23, 2015 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Mid Hudson Physicians, P.C. Internal Medicine CurrentSince Aug 8, 2011 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Nov 27, 2013 Accepting new patients
Samaritan Hospital of Troy, New York Internal Medicine CurrentSince Jan 8, 2018 Accepting new patients
Ny Acute Care Specialists PC Hospitalist Past Accepting new patients
Arnot Ogden Medical Center Past Accepting new patients
Inpatient Medical Associates of New York PLLC Hospitalist Past Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396837795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 CLASSON AVE",
            "address_2": "#5L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384647",
            "telephone_number": "646-403-1976",
            "fax_number": "347-365-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-523-4555",
            "fax_number": "228-523-4515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Avenue",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "12180",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMAL",
        "first_name": "KAMALELDIN",
        "middle_name": "HASSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239518",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "239518",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01057156A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01057156A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000754235",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200899750",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.