Individual provider Active NPI

Mahmoud I Ismail, MD

  • Internal Medicine Physician
  • Erie, PA
National Provider Identifier
1912903253
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD429239 Issued in PA
Practice address
201 State Street
Hamot Faculty Specialists
Erie, PA 16550-0002
Phone
(814) 877-6000
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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 226415 NY
Internal Medicine Physician 207R00000X MD429239 PA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 226415 NY

Addresses

Primary practice location

201 State Street
Hamot Faculty Specialists
Erie, PA 16550-0002

Mailing address

717 State Street
Suite 16 LL Regional Health Services, Inc
Erie, PA 16501-1360
Phone (814) 480-7100

Other identifiers 1

IdentifierTypeStateIssuer
101736840MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050713000323 NY Practitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Hospitalist 4789610577 Reassigns benefits to 1 organization
I20070119000275 PA Practitioner - Internal Medicine 4789610577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine, Hospitalist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Academic Medicine Services, Inc.Group PAC ID 0941105241, 115 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226415NYMDInternal Medicine Physician
MD429239PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc Current Accepting new patients
Academic Medicine Services, Inc. Internal Medicine CurrentSince Jul 25, 2016 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Feb 3, 2015 Accepting new patients
Warren General Hospital Internal Medicine PastSince Apr 1, 2006 Accepting new patients
Warren General Hospital Past Accepting new patients
Kaleida Health Past Accepting new patients
Erie County Medical Center Corporation Past Accepting new patients

Locations

462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

4498 Main St
Ste 23
Buffalo, NY 14226

505 Foote Ave
Jamestown, NY 14701
Phone (716) 483-2285

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

Interoperability endpoints

  • Direct secure messaging: mismail@direct.excelahealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1912903253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 STATE STREET",
            "address_2": "SUITE 16 LL REGIONAL HEALTH SERVICES, INC",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011360",
            "telephone_number": "814-480-7100",
            "fax_number": "814-480-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STATE STREET",
            "address_2": "HAMOT FACULTY SPECIALISTS",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "MAHMOUD",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "226415",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD429239",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "226415",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101736840",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.