Active NPI
Nasser Mikhail Gayed, M.D.
- Internal Medicine Physician
- Peoria, IL
National Provider Identifier
1720099195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-075680
- Practice address
- 411 Martin Luther King Jr Dr
Peoria, IL 61605-2414 - Phone
- (309) 497-0790
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-075680 | IL | Primary |
Addresses
Primary practice location
411 Martin Luther King Jr Dr
Peoria, IL 61605-2414
Mailing address
2401 W Alta Rd
Apt 1306
Peoria, IL 61615-1279
Phone (815) 822-8516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130503000564 | IL | Order and Referring Only - Internal Medicine | 4880831189 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-075680 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1720099195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 W ALTA RD",
"address_2": "APT 1306",
"city": "PEORIA",
"state": "IL",
"postal_code": "616151279",
"telephone_number": "815-822-8516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 MARTIN LUTHER KING JR DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616052414",
"telephone_number": "309-497-0790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYED",
"first_name": "NASSER",
"middle_name": "MIKHAIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-075680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.