Individual provider Active NPI

Ahmed Mostafa Jlasi, MD

  • Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1801386412
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD493484 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-4600
NPI assigned
May 18, 2018
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.071800 IL
Internal Medicine Physician 207R00000X 01086260A IN
Nephrology Physician 207RN0300X MD493484 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Other practice location 1

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (312) 375-4239

Other practice location 2

2625 E 62nd St
Indianapolis, IN 46220-3189
Phone (317) 251-6121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajlasi@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260302001350 PA Practitioner - Internal Medicine 0840697447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3500 N Broad St
RM 1a
Philadelphia, PA 19140-4106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.071800ILMDInternal Medicine Physician
01086260AINMDInternal Medicine Physician
MD493484PAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Feb 1, 2026 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Feb 1, 2026 Accepting new patients
Iu Health Medical Group, LLC PastSince Feb 1, 2026 Accepting new patients

Locations

1316 W Ontario St
Philadelphia, PA 19140
Phone (215) 707-2400

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

Interoperability endpoints

  • Direct secure messaging: ajlasi@direct.iuhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1801386412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081782",
            "country_code": "US",
            "telephone_number": "312-375-4239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2625 E 62nd St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462203189",
            "country_code": "US",
            "telephone_number": "317-251-6121",
            "fax_number": "317-257-0390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JLASI",
        "first_name": "AHMED",
        "middle_name": "MOSTAFA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-18",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.071800",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01086260A",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD493484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajlasi@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2625 E 62nd St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462203189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.