Individual provider Active NPI

Amr Albadrawy Ali Aboelnasr, MD

  • Hospitalist Physician
  • Montgomery, OH
National Provider Identifier
1417534876
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.149308 Issued in OH
Practice address
10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone
(513) 865-2246
Fax
(513) 865-5552
NPI assigned
Mar 24, 2021
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 35.149308 OH Primary

Addresses

Primary practice location

10500 Montgomery Rd
Montgomery, OH 45242-4402

Mailing address

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 865-2246

Other practice location 1

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260128001678 IL Practitioner - Internal Medicine 7618385618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1950 W Polk St
Chicago, IL 60612-3723

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.149308OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Hospitalist CurrentSince Jan 16, 2026 Accepting new patients
Cook County CurrentSince Jan 16, 2026 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1417534876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-865-2246",
            "fax_number": "513-865-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-865-2246",
            "fax_number": "513-865-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Dixmyth Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452202475",
            "country_code": "US",
            "telephone_number": "513-862-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABOELNASR",
        "first_name": "AMR",
        "middle_name": "ALBADRAWY ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.149308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.