NPIMap

Organization Active NPI

Obstetrics and Gynecology and Gynecologic Oncology PC

  • Gynecologic Oncology Physician
  • Sioux Falls, SD
National Provider Identifier
1669544763
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
SD2615 Issued in SD
Legal business name
OBSTETRICS AND GYNECOLOGY AND GYNECOLOGIC ONCOLOGY PC
Practice address
1000 E 21St St
Suite 3000
Sioux Falls, SD 57105-1035
Phone
(605) 331-3898
Fax
(605) 331-3967
NPI assigned
Nov 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Samir Z Abu-Ghazaleh, MDNPI 1821066184
Title
President
Phone
(605) 331-3898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0201X SD2615 SD Primary

Addresses

Primary practice location

1000 E 21St St
Suite 3000
Sioux Falls, SD 57105-1035

Mailing address

1000 E 21St St
Suite 3000
Sioux Falls, SD 57105-1035
Phone (605) 331-3898

Other identifiers 2

IdentifierTypeStateIssuer
6200290MedicaidSD
0925370MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669544763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 21ST ST",
            "address_2": "SUITE 3000",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051035",
            "telephone_number": "605-331-3898",
            "fax_number": "605-331-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 21ST ST",
            "address_2": "SUITE 3000",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051035",
            "telephone_number": "605-331-3898",
            "fax_number": "605-331-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRICS AND GYNECOLOGY AND GYNECOLOGIC ONCOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABU-GHAZALEH",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-331-3898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "SD",
            "license": "SD2615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6200290",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925370",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.