Individual provider Active NPI

Medhat A. El-Sabawy, PA-C

  • Medical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1629482989
Registry record updated Nov 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2015-0021 Issued in NM
Practice address
1100 Lead SE
PMG Gi
Albuquerque, NM 87106-5215
Phone
(505) 224-7000
NPI assigned
Jun 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2015-0021 NM
Medical Physician Assistant 363AM0700X PA2015-0021 NM Primary

Addresses

Primary practice location

1100 Lead SE
PMG Gi
Albuquerque, NM 87106-5215

Mailing address

1100 Lead Ave SE
Albuquerque, NM 87106-5215
Phone (505) 224-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114003184 MD Practitioner - Physician Assistant 2668694688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Jan 20, 2020 Accepting new patients
Tidalhealth Peninsula Regional, Inc. Physician Assistant CurrentSince Jan 20, 2020 Accepting new patients

Locations

10344 Old Ocean City Blvd
Berlin, MD 21811
Phone (410) 641-4582

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

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, 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": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699660800000",
    "number": "1629482989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LEAD AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065215",
            "telephone_number": "505-224-7000",
            "fax_number": "505-224-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LEAD SE",
            "address_2": "PMG GI",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065215",
            "telephone_number": "505-224-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-SABAWY",
        "first_name": "MEDHAT",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-15",
        "last_updated": "2023-11-11",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2015-0021",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2015-0021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.