Individual provider Active NPI

Mohamed M. Elagami, MD

  • Gastroenterology Physician
  • Hackensack, NJ
National Provider Identifier
1417440439
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA11082800 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-3091
NPI assigned
Jun 13, 2018
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA11082800 NJ
Hospitalist Physician 208M00000X 25MA11082800 NJ
Gastroenterology Physician 207RG0100X 25MA11082800 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

331 Newman Springs Rd
BLDG 2, Ste 220
Red Bank, NJ 07701-5688

Other practice location 1

30 Prospect Ave Rm 3847
Hackensack, NJ 07601-1915
Phone (551) 996-1300

Other practice location 2

30 Prospect Ave Rm 3847
Hackensack, NJ 07601-1915
Phone (551) 996-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20211115002118 NJ Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Hospitalist 1557750437 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-1288

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy26
Upper gastrointestinal (GI) endoscopy for acid reflux95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11082800NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 14, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Internal Medicine CurrentSince Jul 14, 2025 Accepting new patients
St. Joseph's Healthcare, Inc. Internal Medicine CurrentSince Dec 15, 2021 Accepting new patients
Bergen County Improvement Authority Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

30 Prospect Ave
Rm 3847
Hackensack, NJ 07601
Phone (551) 996-1300

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

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

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 6

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 3

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1417440439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-3091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave Rm 3847",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Prospect Ave Rm 3847",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELAGAMI",
        "first_name": "MOHAMED",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11082800",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA11082800",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA11082800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.