NPIMap

Individual provider Active NPI

Mohamed Imam El Bahy Imam, M.D

  • Internal Medicine Physician
  • Lakewood, WA
National Provider Identifier
1497084842
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60579714 Issued in WA
Practice address
11307 Bridgeport Way SW
Lakewood, WA 98499-3024
Phone
(253) 985-6190
Fax
(253) 944-6986
NPI assigned
Dec 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125052227 IL
Internal Medicine Physician 207R00000X MD60579714 WA Primary

Addresses

Primary practice location

11307 Bridgeport Way SW
Lakewood, WA 98499-3024

Mailing address

11307 Bridgeport Way SW
Lakewood, WA 98499-3024
Phone (253) 985-6190

Other identifiers 1

IdentifierTypeStateIssuer
2048593MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mimam147018@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20151030000357 WA Practitioner - HospitalistPractitioner - Internal Medicine 2961684204 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians
Summit Consulting for Post Acute Care LLCGroup PAC ID 7416201751, 12 clinicians

Practice addresses (Care Compare)

11307 Bridgeport Way SW
Suite 220B
Lakewood, WA 98499-3024
Phone (253) 944-3278

1170 Alki Ave SW
Apt 301
Seattle, WA 98116-4828
Phone (206) 595-3383

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Highline Medical Center Hospital, Burien, WA, CCN 500011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125052227ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Tran Urgent Care & Wellness Centers LLC CurrentSince Mar 1, 2024 Accepting new patients
Summit Consulting for Post Acute Care LLC Internal Medicine CurrentSince Jul 18, 2024 Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Nov 18, 2017 Accepting new patients
Franciscan Health System Past Accepting new patients
Impact Health Biometric Testing, Inc. Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

11307 Bridgeport Way SW
Ste 220B
Lakewood, WA 98499
Phone (253) 944-3278

3000 Limited Ln NW
Olympia, WA 98502
Phone (360) 357-9392

4409 NW Anderson Hill Rd
Silverdale, WA 98383
Phone (360) 698-6012

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

516 S 38th St
Ste A
Tacoma, WA 98418
Phone (206) 579-8905

710 S 38th St
Ste B
Tacoma, WA 98418
Phone (253) 719-7767

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21373/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 8

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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1497084842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11307 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993024",
            "telephone_number": "253-985-6190",
            "fax_number": "253-944-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11307 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993024",
            "telephone_number": "253-985-6190",
            "fax_number": "253-944-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "MOHAMED",
        "middle_name": "IMAM EL BAHY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125052227",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60579714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048593",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mimam147018@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11307 Bridgeport Way SW",
            "city": "Lakewood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984993024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.