Individual provider Active NPI

Hamma Ahmadou Diallo, M.D.

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1730155177
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 103206 Issued in FL
Practice address
6000 W Highway 98
Pensacola, FL 32512-0001
Phone
(850) 505-6868
NPI assigned
Feb 26, 2006
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301084617 MI
Family Medicine Physician 207Q00000X ME 103206 FL Primary

Addresses

Primary practice location

6000 W Highway 98
Pensacola, FL 32512-0001

Mailing address

2104 Massey Ave
Jacksonville, FL 32228
Phone (904) 270-5023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130125000145 FL Practitioner - Family Practice 1759535875 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 103206FLMDFamily Medicine Physician
4301084617MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc CurrentSince Jan 1, 2013 Accepting new patients
Emergency Physicians Inc CurrentSince Jan 1, 2013 Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

820 Prudential Dr
Ste 713
Jacksonville, FL 32207
Phone (800) 936-5996

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.

NPI Registry JSON

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

{
    "created_epoch": "1140912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1730155177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 MASSEY AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32228",
            "telephone_number": "904-270-5023",
            "fax_number": "904-270-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 W HIGHWAY 98",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325120001",
            "telephone_number": "850-505-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIALLO",
        "first_name": "HAMMA",
        "middle_name": "AHMADOU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-26",
        "last_updated": "2024-08-05",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301084617",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 103206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.