NPIMap

Individual provider Active NPI

Ahmed Eltanbedawi, MD

  • Internal Medicine Physician
  • Springfield, MA
National Provider Identifier
1609379775
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
290279 Issued in MA
Practice address
759 Chestnut St
Springfield, MA 01199-1001
Phone
(413) 794-6297
Fax
(413) 794-1767
NPI assigned
Mar 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 290279 MA
Student in an Organized Health Care Education/Training Program 390200000X 273399 MA
Internal Medicine Physician 207R00000X 290279 MA Primary

Addresses

Primary practice location

759 Chestnut St
Springfield, MA 01199-1001

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211227000055 MA Practitioner - Internal Medicine 3577825736 Reassigns benefits to 1 organization
I20241211003115 CT Practitioner - Internal MedicinePractitioner - Geriatric Medicine 3577825736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-8121

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549

Hospital & facility affiliations

  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290279MAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley Internal Medicine CurrentSince Jan 8, 2026 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jan 8, 2026 Accepting new patients
Baystate Medical Practices, Inc Internal Medicine CurrentSince Dec 17, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jan 1, 2025 Accepting new patients
Baystate Medical Center Inc Past Accepting new patients

Locations

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

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 8

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": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1609379775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-6297",
            "fax_number": "413-794-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTANBEDAWI",
        "first_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "290279",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "273399",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "290279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.