Individual provider Active NPI

Abdelhafeez H Abdelhafeez, MD

  • Pediatric Surgery Physician
  • Memphis, TN
National Provider Identifier
1558619213
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
57019 Issued in TN
Practice address
262 Danny Thomas PL
Memphis, TN 38105
Phone
(888) 226-4343
NPI assigned
Aug 28, 2012
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 57621 WI
Pediatric Surgery Physician 2086S0120X 57019 TN Primary

Addresses

Primary practice location

262 Danny Thomas PL
Memphis, TN 38105

Mailing address

262 Danny Thomas PL # Ms 515
Memphis, TN 38105-3678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250128000528 NY Practitioner - General Surgery 0547799116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Rochester Surgical AssociatesGroup PAC ID 8022919232, 51 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-8410
Phone (585) 275-1984

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57019TNMDPediatric Surgery Physician
57621WIMDPediatric Surgery Physician
333422NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester Surgical Associates Pediatric Surgery CurrentSince Jan 1, 2025 Accepting new patients
University of Rochester Past Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#320
Rochester, NY 14642

601 Elmwood Ave
#648
Rochester, NY 14642
Phone (585) 275-1376

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1558619213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL # MS 515",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38105",
            "telephone_number": "888-226-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELHAFEEZ",
        "first_name": "ABDELHAFEEZ",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "WI",
            "license": "57621",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TN",
            "license": "57019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.