NPIMap

Individual provider Active NPI

Aymen Ahmed Kenawy, M.D.

  • Rheumatology Physician
  • Lynn Haven, FL
National Provider Identifier
1770780603
Registry record updated Jul 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
ME 104930 Issued in FL
Practice address
3890 Jenks Ave
Lynn Haven, FL 32444-4701
Phone
(850) 215-6400
Fax
(850) 215-4440
NPI assigned
Jul 3, 2007
Last updated
Jul 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN11579 FL
Rheumatology Physician 207RR0500X ME 104930 FL Primary

Addresses

Primary practice location

3890 Jenks Ave
Lynn Haven, FL 32444-4701

Mailing address

3890 Jenks Ave
Lynn Haven, FL 32444-4701
Phone (850) 215-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110801000254 FL Practitioner - RheumatologyPractitioner - Internal Medicine 5991973380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emerald Coast Rheumatology LLCGroup PAC ID 7810165206, 9 clinicians

Practice addresses (Care Compare)

2202 State Ave
Suite 104
Panama City, FL 32405-4539
Phone (850) 876-6693

3890 Jenks Ave
Lynn Haven, FL 32444-4701
Phone (850) 215-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as individual
Quality
74.88
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN11579FLMDInternal Medicine Physician
ME 104930FLMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Coast Rheumatology LLC Internal Medicine CurrentSince May 1, 2011 Accepting new patients
World Healthcare and Consulting, LLC. Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

3890 Jenks Ave
Lynn Haven, FL 32444
Phone (850) 215-6400

Interoperability endpoints

  • Direct secure messaging: aymen.kenawy.1@3219.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3219/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 5

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469923200000",
    "number": "1770780603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 JENKS AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444701",
            "telephone_number": "850-215-6400",
            "fax_number": "850-215-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 JENKS AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444701",
            "telephone_number": "850-215-6400",
            "fax_number": "850-215-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENAWY",
        "first_name": "AYMEN",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2016-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN11579",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME 104930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn Haven, FL

Sources for this page

Verify at the official NPI Registry.