Individual provider Active NPI

Mohamed Elshewy, BDS, MSC, MS, FACP

  • Prosthodontics
  • Augusta, GA
National Provider Identifier
1538836556
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DNF000448 Issued in GA
Practice address
1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001
Phone
(706) 721-2371
NPI assigned
Aug 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DNCS000668 GA
Prosthodontics 1223P0700X DNF000448 GA Primary
Prosthodontics 1223P0700X 019.032958 IL

Addresses

Primary practice location

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001

Mailing address

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001
Phone (706) 721-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815001122 GA Practitioner - Prosthodontics 5890157549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Prosthodontics
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 670747
Marietta, GA 30066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DNCS000668GAMDProsthodontist
019.032958ILMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1538836556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSHEWY",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "BDS, MSC, MS, FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DNCS000668",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DNF000448",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019.032958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.