Ahmed Muthanna Al-Tabaqchali, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME169270 Issued in FL

Practice address

2001 Kingsley Ave
Orange Park, FL 32073-5148

Phone

(904) 639-8500

NPI assigned

Jun 2, 2020

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NY2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Port Emergency Medical Services PCGroup PAC ID 1456376177, 41 clinicians

Apogee Medical Group, Florida IncGroup PAC ID 4082878509, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parrish Medical Center Hospital, Titusville, FL, CCN 100028
• St John's Episcopal Hospital at South Shore Hospital, Far Rockaway, NY, CCN 330395

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Apogee Medical Group, Florida, Inc.

  • Hospitalist Physician
  • Titusville, FL
  • NPI 1386916104

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Port Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Port Jefferson, NY
  • NPI 1912988395

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597

  Single Specialty

  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164

  Internal Medicine

  NPD
• Inpatient Consultants of Florida, Inc

  • Hospitalist Physician
  • Clearwater, FL
  • NPI 1811179831

  Internal Medicine

  NPD
• Narendra R Kumar M.D, PC

  • Otolaryngology Physician
  • Saginaw, MI
  • NPI 1417039603

  Single Specialty

  NPD
• Episcopal Health Services Inc

  dba St John's Episcopal Hospital SS

  • General Acute Care Hospital
  • Far Rockaway, NY
  • NPI 1346274537
  NPD (past)
• Sound a Sleep PLC

  • Sleep Medicine (Otolaryngology) Physician
  • Saginaw, MI
  • NPI 1174576102

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Brevard County Hospital District

  dba Parrish Medical Center

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1689298945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 E HAMMOND LAKE DR",
            "city": "BLOOMFIELD TWP",
            "state": "MI",
            "postal_code": "48302",
            "telephone_number": "212-423-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735148",
            "telephone_number": "904-639-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-TABAQCHALI",
        "first_name": "AHMED",
        "middle_name": "MUTHANNA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME169270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad I Akhtar, M.D.
• Sadia Akram
• Maria Al Chammas, DMD
• Rami Al Saidi
• Youssef Al-Saghir, MD
• Sadie Alavi
• Rick Albarran, ARNP
• Albert L Henry, MD
• Alishia Albritton
• Runelon Alcudia, ARNP

• Internal Medicine Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.