Individual provider Active NPI

Mohamed Bader El Safadi, MD

  • Gastroenterology Physician
  • Newport News, VA
National Provider Identifier
1679750657
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101243036 Issued in VA
Practice address
11751 Rock Landing Dr Ste 1
Newport News, VA 23606-4233
Phone
(757) 240-2700
Fax
(757) 240-2701
NPI assigned
Jan 22, 2008
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101243036 VA Primary

Addresses

Primary practice location

11751 Rock Landing Dr Ste 1
Newport News, VA 23606-4233

Mailing address

860 Omni Blvd Ste 101
Newport News, VA 23606-4430
Phone (757) 232-8769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080625000734 VA Practitioner - GastroenterologyPractitioner - Internal Medicine 2961573555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Bernadine Dr
Newport News, VA 23602-4404
Phone (757) 886-6877

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy125
Upper gastrointestinal (GI) endoscopy for acid reflux126

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Mar 1, 2008 Accepting new patients
Tidewater Physicians Multispecialty Group PC Gastroenterology CurrentSince Mar 1, 2008 Accepting new patients

Locations

11751 Rock Landing Dr
Ste 1
Newport News, VA 23606
Phone (757) 240-2700

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

860 Omni Blvd
Ste 301A
Newport News, VA 23606

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1679750657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11751 ROCK LANDING DR STE 1",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064233",
            "telephone_number": "757-240-2700",
            "fax_number": "757-240-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL SAFADI",
        "first_name": "MOHAMED",
        "middle_name": "BADER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-22",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101243036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.