Ahmed Elbermawy, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

5781201 Issued in ID

Practice address

1072 N Liberty St Ste 303
Boise, ID 83704-8708

Phone

(208) 302-4200

Fax

(208) 302-4255

NPI assigned

Jun 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1770144735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-302-9342",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY ST STE 303",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048708",
            "telephone_number": "208-302-4200",
            "fax_number": "208-302-4255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-624-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELBERMAWY",
        "first_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ID",
            "license": "5781201",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Eisenbeiss Sr., PSYCHOLOGIST COUNSEL
• Amanda P Eisenberg, LPC, LAMFT
• Mary-Katherine Ekins, MS, LPC
• Philip Resin Elackatt, RN
• Elaine Key MD PLLC
• Jacquie Anne Elcox, BC- HIS
• Khaled Eldemerdash, RPH
• Becky M. Elder, NP
• Douglas Scott Elder, CRNA
• Kerry Elder

• Neurology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Neurology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.

Verify at the official NPI Registry.