NPIMap

Individual provider Active NPI

Mostafa Abdalla Amr, M.D.

  • Nephrology Physician
  • Lexington, KY
National Provider Identifier
1689694598
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
37363 Issued in KY
Practice address
2101 Nicholasville Rd Ste 208
Lexington, KY 40503-2525
Phone
(859) 373-1176
Fax
(859) 275-0028
NPI assigned
Jul 20, 2006
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37363 KY
Nephrology Physician 207RN0300X 37363 KY Primary

Addresses

Primary practice location

2101 Nicholasville Rd Ste 208
Lexington, KY 40503-2525

Mailing address

PO Box 910277
Lexington, KY 40591-0277
Phone (859) 373-1176

Other identifiers 1

IdentifierTypeStateIssuer
64056732MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20101115000536 KY Practitioner - NephrologyPractitioner - Internal Medicine 1456546050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2101 Nicholasville Rd
Suite 303
Lexington, KY 40503-2526
Phone (859) 373-1176

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37363KYMDNephrology Physician
19111SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ky Nephrology & Hypertension Nephrology CurrentSince Sep 1, 2010 Accepting new patients
Internal Medicine & Infectious Diseases Specialists Past Accepting new patients
Nephrology Consultants of Jacksonville LLC Nephrology Past Accepting new patients
Dialysis Clinic Inc. Nephrology Past Accepting new patients

Locations

1451 Harrodsburg Rd
Ste D304
Lexington, KY 40504
Phone (859) 317-1673

2101 Nicholasville Rd
Ste 208
Lexington, KY 40503
Phone (859) 276-5454

2101 Nicholasville Rd
Ste 303
Lexington, KY 40503
Phone (859) 277-7281

Organizations & group practices 4

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 7

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1689694598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910277",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405910277",
            "telephone_number": "859-373-1176",
            "fax_number": "859-275-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NICHOLASVILLE RD STE 208",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032525",
            "telephone_number": "859-373-1176",
            "fax_number": "859-275-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMR",
        "first_name": "MOSTAFA",
        "middle_name": "ABDALLA",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "37363",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "37363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64056732",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.