NPIMap

Individual provider Active NPI

Mohamed S Elnaggar, M.D.

  • Internal Medicine Physician
  • Wyandotte, MI
National Provider Identifier
1770563256
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME063139 Issued in MI
Practice address
995 Ford Ave
Wyandotte, MI 48192-3861
Phone
(734) 284-3100
Fax
(734) 284-8212
NPI assigned
Jan 19, 2006
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME063139 MI Primary

Addresses

Primary practice location

995 Ford Ave
Wyandotte, MI 48192-3861

Mailing address

24758 Roosevelt CT
Farmington Hills, MI 48335-1872
Phone (248) 960-5789

Other identifiers 1

IdentifierTypeStateIssuer
4437430MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040920001023 MI Practitioner - Internal Medicine 7911975735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sita Medical ClinicGroup PAC ID 6507882826, 3 clinicians

Practice addresses (Care Compare)

995 Ford Ave
Wyandotte, MI 48192-3861
Phone (734) 284-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME063139MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sita Medical Clinic Internal Medicine CurrentSince Oct 1, 2002 Accepting new patients
Satinder Kumar Aggarwal MD P C Internal Medicine Past Accepting new patients
Millennium Medical Group South PC Internal Medicine PastSince Oct 1, 2002 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

995 Ford Ave
Wyandotte, MI 48192
Phone (734) 284-3100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCJGBD
  • Direct secure messaging: megha@sitamedical.gwaydirect.com
  • Direct secure messaging: melnaggar59924@direct.hfhs.org
  • Direct secure messaging: mohamed.elnaggar@smc995.eclinicaldirectplus.com
  • Direct secure messaging: mohamed@sitamedical.gwaydirect.com

Organizations & group practices 5

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 4

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1770563256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24758 ROOSEVELT CT",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483351872",
            "telephone_number": "248-960-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923861",
            "telephone_number": "734-284-3100",
            "fax_number": "734-284-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELNAGGAR",
        "first_name": "MOHAMED",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "ME063139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4437430",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.