NPIMap

Individual provider Active NPI

Sherif Naguib Gobrial, M.D.,

  • Internal Medicine Physician
  • West Allis, WI
National Provider Identifier
1477781102
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54735-20 Issued in WI
Practice address
2514 S 102ND St
Suite 160
West Allis, WI 53227-2142
Phone
(414) 255-0300
NPI assigned
Jul 1, 2009
Last updated
Jul 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301094403 MI
Internal Medicine Physician 207R00000X 54735-20 WI Primary
General Practice Physician 208D00000X 54735-20 WI

Addresses

Primary practice location

2514 S 102ND St
Suite 160
West Allis, WI 53227-2142

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110114001092 WI Practitioner - Internal Medicine 6002005451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Brookfield, WI 53005
Phone (414) 255-0300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54735-20WIMDInternal Medicine Physician
4301094403MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
Vpa PC Internal Medicine CurrentSince Sep 20, 2010 Accepting new patients
Vpa PC Internal Medicine CurrentSince Sep 20, 2010 Accepting new patients
Iah of Wisconsin, PLLC CurrentSince Jan 1, 2015 Accepting new patients

Locations

13555 Bishops Ct
Ste 315
Brookfield, WI 53005
Phone (414) 255-0300

2514 S 102nd St
Ste 160
West Allis, WI 53227
Phone (414) 255-0300

Interoperability endpoints

  • Direct secure messaging: sherif.gobrial.1@32913.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1477781102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST",
            "address_2": "SUITE 160",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-255-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBRIAL",
        "first_name": "SHERIF",
        "middle_name": "NAGUIB",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301094403",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "54735-20",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "54735-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.