Ahmed Eldessouky, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301507856 Issued in MI

Practice address

505 N Jackson St
Jackson, MI 49201-1266

Phone

(517) 748-5500

NPI assigned

Jun 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aeldessouky867058@direct.hfhs.org

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.

• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1780784439

  Pediatrics

  Medicare reassignment NPD
• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1710764410

  Pediatrics

  NPD
• Campground Pediatrics Wellness Center

  • Pediatrics Physician
  • Washington Township, MI
  • NPI 1699285023
  NPD (past)

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1528629946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60005 Campground Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MI",
            "postal_code": "480943446",
            "country_code": "US",
            "telephone_number": "862-325-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELDESSOUKY",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301507856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4351044319",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamed El Fakiy, MD
• Iman El-Feki, MD
• Mahmoud H El-Yassir, MD
• Elara Caring Palliative Care, PC
• Prasanth Elavarthy
• Ahmed Ibrahim Eldewak, MD
• Hesham Elewa
• Karim Elghawy, M.D.
• Elite Care, LLC
• Elizabeth J. Rutledge, DDS, PLC (Springcrest Dental Associates)

• Pediatrics Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.