Mohammad Eldomery, M.D.

Primary specialty

Molecular Genetic Pathology (Pathology) PhysicianTaxonomy code 207ZP0007X

License

63826 Issued in TN

Practice address

262 Danny Thomas PL
Memphis, TN 38105-3678

Phone

(888) 226-4343

NPI assigned

Jun 24, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Interoperability endpoints

• Direct secure messaging: meldomery21330@stjude.direct-ci.com

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.

• St Jude Children'S Research Hospital, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1306335088
  Medicare reassignment

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1588015143",
    "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": "381053678",
            "telephone_number": "888-226-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDOMERY",
        "first_name": "MOHAMMAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018989A",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "63826",
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "TN",
            "license": "63826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheran Elangovan, M.D.,
• Lama Ma Elbahlawan, MD
• Elder Care Social Services
• Elder Care, Inc.
• Clyde H Elder Jr., APRN,BC
• Elect Home Care, LLC
• Darryl Elefan, M.D.
• Elements of Life
• Shelby Nichole Elenburg, M.D.
• Elevate Memphis Inc

• Molecular Genetic Pathology (Pathology) Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Molecular Genetic Pathology (Pathology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.