NPIMap

Organization Active NPI

Mamdouh Riad MD PC

  • Specialist
  • Hyannis, MA
National Provider Identifier
1639279342
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
76855 Issued in MA
Legal business name
MAMDOUH RIAD MD PC
Practice address
100 Independence Dr Ste 3
Hyannis, MA 02601-1898
Phone
(508) 790-4568
Fax
(508) 790-1800
NPI assigned
Sep 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Ashley Goldsmith
Title
Coo
Phone
(402) 202-5823

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 76855 MA Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

100 Independence Dr Ste 3
Hyannis, MA 02601-1898

Mailing address

100 Independence Dr Ste 3
Hyannis, MA 02601-1898
Phone (508) 790-4568

Other identifiers 1

IdentifierTypeStateIssuer
110000226BMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080117000449 MA Part B Supplier - Clinic/Group Practice 5193806941 Receives reassigned benefits from 18 practitioners
Practice locations: Hyannis, MA

National Provider Directory

National Provider Directory

Locations

51 Main St
Ste 2
Hyannis, MA 02601
Phone (508) 775-3112

100 Independence Dr
Ste 3
Hyannis, MA 02601
Phone (508) 790-4568

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2967/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1639279342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 INDEPENDENCE DR STE 3",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011898",
            "telephone_number": "508-790-4568",
            "fax_number": "508-790-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDEPENDENCE DR STE 3",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011898",
            "telephone_number": "508-790-4568",
            "fax_number": "508-790-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMDOUH RIAD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "402-202-5823"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "76855",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110000226B",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.