Individual provider Active NPI

Abdelwahab Ahmed Abdelwahab Jalal Eldin, MD

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1730717430
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02550 Issued in NC
Practice address
2041 Georgia Avenue NW Howard University Hospital
Washington, DC 20060-0001
Phone
(202) 568-3352
NPI assigned
Mar 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 02550 NC Primary

Addresses

Primary practice location

2041 Georgia Avenue NW Howard University Hospital
Washington, DC 20060-0001

Mailing address

2041 Georgia Avenue NW Howard University Hospital
Washington, DC 20060-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230927003768 NC Practitioner - Internal Medicine 0941654743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group North CarolinaGroup PAC ID 7719162254, 78 clinicians

Practice addresses (Care Compare)

1705 Tarboro St SW
Wilson, NC 27893-3428
Phone (252) 399-8040

Hospital & facility affiliations

  • Wilson Medical Center Hospital, Wilson, NC, CCN 340126

Merit-based Incentive Payment System (MIPS)

Final score
95.67 of 100Reported as group
Quality
88.12
Improvement activities
40
Cost
77.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02550NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group North Carolina CurrentSince Sep 1, 2023 Accepting new patients

Locations

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1730717430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVENUE NW HOWARD UNIVERSITY HOSPITAL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVENUE NW HOWARD UNIVERSITY HOSPITAL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-568-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALAL ELDIN",
        "first_name": "ABDELWAHAB",
        "middle_name": "AHMED ABDELWAHAB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "02550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.