Mahmoud Abu-Ghanam Physician, P.C.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

MAHMOUD ABU-GHANAM PHYSICIAN, P.C.

Practice address

1987 State Route 52 Ste 10
Liberty, NY 12754-8317

Phone

(845) 292-0078

Fax

(845) 292-3244

NPI assigned

Nov 17, 2022

Organization subpart

No

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

Authorized official

Name

Mahmoud Abu Ghanam, MDNPI 1912952540

Title

Owner

Phone

(845) 707-3092

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Mahmoud Abu Ghanam, MD

  • Interventional Pain Medicine Physician
  • Liberty, NY
  • NPI 1912952540
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1669181780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "127340190",
            "telephone_number": "845-292-0078",
            "fax_number": "845-292-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1987 STATE ROUTE 52 STE 10",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127548317",
            "telephone_number": "845-292-0078",
            "fax_number": "845-292-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHMOUD ABU-GHANAM PHYSICIAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "ABU GHANAM",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-707-3092",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darlene H Loiacono, MSW
• Maryanne Lombardo, D.C.
• Makenna Taylor Loucks, RN, BSN
• Elisabeth Ellen Lowe, R.N.
• Felissa Lulkin, OTA
• Steven Michael Manchik, RPH
• Mark A Mason
• Joseph Patrick Maxwell Jr.
• Stephanie McClain, LMSW
• Megan McCormack, PMHNP

• Pain Medicine (Anesthesiology) Physician in Liberty, NY
• Providers in Liberty, NY by specialty
• Pain Medicine (Anesthesiology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.