Individual provider Active NPI

Aysam H Mahmoud, MD

  • Internal Medicine Physician
  • Kokomo, IN
National Provider Identifier
1598228629
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01088077A Issued in IN
Practice address
1907 W Sycamore St
Kokomo, IN 46901-5148
Phone
(765) 456-5433
NPI assigned
Apr 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME154760 FL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 01088077A IN Primary

Addresses

Primary practice location

1907 W Sycamore St
Kokomo, IN 46901-5148

Mailing address

1907 W Sycamore St
Kokomo, IN 46901-5148

Other practice location 1

11700 N Meridian St
Carmel, IN 46032-4656
Phone (317) 688-5068

Other practice location 2

1125 N College Ave # Slot100
Fayetteville, AR 72703-1908
Phone (479) 713-8310

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amahmoud@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220811000289 IN Practitioner - Internal Medicine 4183007966 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8240 Naab Rd
Suite 155
Indianapolis, IN 46260-1985
Phone (317) 338-7760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME154760FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center Internal Medicine CurrentSince Mar 30, 2025 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Mar 30, 2025 Accepting new patients
University Family Physicians, Inc. Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Mar 30, 2025 Accepting new patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Mar 30, 2025 Accepting new patients
University Family Physicians, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1907 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5611

Organizations & group practices 6

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 4

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": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1598228629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 W SYCAMORE ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469015148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W SYCAMORE ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469015148",
            "telephone_number": "765-456-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11700 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460324656",
            "country_code": "US",
            "telephone_number": "317-688-5068",
            "fax_number": "317-688-2833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1125 N College Ave # Slot100",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "479-713-8310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHMOUD",
        "first_name": "AYSAM",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-06",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME154760",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01088077A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amahmoud@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11700 N Meridian St",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460324656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.