NPIMap

Individual provider Active NPI

Maged Takawy Ghaly, MD

  • Internal Medicine Physician
  • Florence, AL
National Provider Identifier
1659930253
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT218153 Issued in PA
Practice address
1701 Veterans Dr
Florence, AL 35630-4928
Phone
(256) 629-1950
Fax
(256) 629-2765
NPI assigned
Jun 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT218153 PA Primary

Addresses

Primary practice location

1701 Veterans Dr
Florence, AL 35630-4928

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-9104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715001023 FL Practitioner - Internal Medicine 7517294143 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Hospital & facility affiliations

  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT218153PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Associates All Florida, LLC Internal Medicine CurrentSince Aug 15, 2022 Accepting new patients
Quantum Inpatient Medical Services LLC CurrentSince Aug 15, 2022 Accepting new patients
Premier Medical Associates of Florida Healthcare, PA Internal Medicine CurrentSince Aug 15, 2022 Accepting new patients
Premier Medical Associates of Florida LLC Internal Medicine CurrentSince Aug 15, 2022 Accepting new patients
Premier Medical Associates of Florida LLC CurrentSince Aug 15, 2022 Accepting new patients

Locations

1004 N 14th St
Ste 109
Leesburg, FL 34748
Phone (352) 978-4888

1580 Santa Barbara Blvd
The Villages, FL 32159
Phone (352) 494-6882

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mghaly594263@direct.shands.ufl.edu

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 12

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": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1659930253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-534-9104",
            "fax_number": "814-534-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 VETERANS DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304928",
            "telephone_number": "256-629-1950",
            "fax_number": "256-629-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHALY",
        "first_name": "MAGED",
        "middle_name": "TAKAWY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT218153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.