Ehab Abdallah Embaby Abdelgyed, M.B.B.CH
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Joplin, MO
NPI 1902467897 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1902467897
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 57.252146 (OH)
- Practice address
- 100 Mercy Way Ste 420
Joplin, MO 64804-4524 - Phone
- (417) 556-3130
- Fax
- (417) 556-3131
- NPI assigned
- Jun 22, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mercy Clinic Joplin LLC
Practice addresses (Care Compare)
100 Mercy Way
580 Mercy Clinic Joplin Diabetes Bridge
Joplin, MO 64804-4524
Phone (417) 556-8555
198 Four States Dr
Suite B
Galena, KS 66739-4304
Phone (620) 783-1358
Hospital & facility affiliations
- Mercy Hospital Joplin
- Mercy Hospital Carthage
- Mercy Hospital Columbus
- Coffeyville Regional Medical Center, Inc
- Mercy Hospital Pittsburg, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240802003405 | MO | Practitioner - Internal Medicine | 6305173089 | Reassigns benefits to 1 organization |
| I20240823003450 | KS | Practitioner - Endocrinology | 6305173089 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-49471 | KS | MD | Endocrinology, Diabetes & Metabolism Physician |
| 57.252146 | OH | MD | Endocrinology, Diabetes & Metabolism Physician |
| 64116 | NY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Joplin LLC | Current |
Accepting new patients | |
| Mercy Clinic Joplin LLC | Current |
Accepting new patients |
Locations
220 N Pennsylvania Ave
Columbus, KS 66725
Phone (620) 429-2545
403 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (417) 556-4762
198 Four States Dr
Ste 2
Galena, KS 66739
Phone (620) 783-2430
100 Mercy Way
Ste 420
Joplin, MO 64804
Phone (417) 556-2278
100 Mercy Way
Ste 580
Joplin, MO 64804
Phone (417) 556-8455
100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 04-49471 | KS | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 2023044753 | MO | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 64116 | NY | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 57.252146 | OH | Yes |
Addresses
Primary practice location
100 Mercy Way Ste 420
Joplin, MO 64804-4524
Mailing address
100 Mercy Way Ste 420
Joplin, MO 64804-4524
Phone (417) 556-3130
Other practice location 1
198 Four States Dr Ste 2
Galena, KS 66739-4305
Phone (620) 783-4101
Other providers in Joplin, MO
- A Bernard Short DDS PC
- A Meaningful Life, LLC
- ABA Hospice Care Mo 1 LLC
- ABA Supportive Care Mo LLC
- Dennis Michael Abbott
- Leith Abdeljaber
- Ahmad Abdin
- Riley Abernathy
- Able Body Chiropractic, PC
- Ahmed Sameh Aboul-Magd
All providers in Joplin, MO · Endocrinology, Diabetes & Metabolism Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.