Ahmed Mohamed Abouelazaem, M.D.
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Brighton, MA
NPI 1639969306 · NPPES record last updated Apr 2, 2026
Key facts
- NPI
- 1639969306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 11 Nevins Street
Medical Office Building (Mob), 3Rd Floor - Room 304
Brighton, MA 02135 - Phone
- (617) 789-2386
- NPI assigned
- May 7, 2025
- Reactivated
- Apr 2, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260515002349 | MA | Order and Referring Only - Internal Medicine |
5799254009 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Interoperability endpoints
- ahmed.abouelazaem.1@2017.direct.athenahealth.com
- aabouelazaem257515@direct.bmc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
11 Nevins Street
Medical Office Building (Mob), 3Rd Floor - Room 304
Brighton, MA 02135
Mailing address
Villa Number 3, Block 6/15, West Somid, 6TH of October
Giza, EGYPT 12566
EG
Other providers in Brighton, MA
- Bayan Abdallah
- Samah Abdallah
- Passant Abdelmegeed
- Ikumi Abe
- Lara Aboud Syriani
- Absolute Care, Inc.
- Mu'Taz Fahid Mezel Abualsha'R
- Angela Achkar
- Kathryn E Ackerman
- Martin A Acquadro
All providers in Brighton, MA · Student in an Organized Health Care Education/Training Program in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.