Individual provider Active NPI

Gabriel Khalil Eljdid, DO

  • Family Medicine Physician
  • Waterloo, IA
National Provider Identifier
1477082634
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05545 Issued in IA
Practice address
1825 Logan Ave Ste 201
Waterloo, IA 50703-1916
Phone
(319) 235-3838
NPI assigned
Jun 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 05545 IA
Family Medicine Physician 207Q00000X 05545 IA Primary

Addresses

Primary practice location

1825 Logan Ave Ste 201
Waterloo, IA 50703-1916

Mailing address

1825 Logan Ave Ste 201
Waterloo, IA 50703-1916
Phone (319) 235-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20200812002974 IA Practitioner - Family Practice 4880963891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3941

Hospital & facility affiliations

  • Allen Hospital Hospital, Waterloo, IA, CCN 160110
  • Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001
  • Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067
  • University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05545IAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Aug 17, 2020 Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine PastSince Aug 9, 2020 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

1825 Logan Ave
Ste 201
Waterloo, IA 50703

Interoperability endpoints

  • Direct secure messaging: geljdid744691@direct.unitypoint.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1477082634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE STE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE STE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELJDID",
        "first_name": "GABRIEL",
        "middle_name": "KHALIL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "05545",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "05545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.