Individual provider Active NPI

Ismail Mohamed Mohamed Awad, PT

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1790501690
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P132327 Issued in NY
Practice address
8031 Broadway
Elmhurst, NY 11373-3160
Phone
(929) 919-6844
Fax
(929) 502-7744
NPI assigned
Nov 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P132327 NY Primary

Addresses

Primary practice location

8031 Broadway
Elmhurst, NY 11373-3160

Mailing address

8031 Broadway
Elmhurst, NY 11373-3160
Phone (929) 919-6844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P132327NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Italy Rehab PT PC CurrentSince Dec 1, 2024 Accepting new patients

Locations

8031 Broadway
Elmhurst, NY 11373
Phone (718) 418-4700

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.

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1790501690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8031 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733160",
            "telephone_number": "929-919-6844",
            "fax_number": "929-502-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733160",
            "telephone_number": "929-919-6844",
            "fax_number": "929-502-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAD",
        "first_name": "ISMAIL",
        "middle_name": "MOHAMED MOHAMED",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "P132327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.