Mohamed Elshazzly, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OP61279697 Issued in WA

Practice address

17700 SE 272ND St
Covington, WA 98042-4951

Phone

(253) 372-6500

NPI assigned

May 2, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  Multi-Specialty

  Medicare reassignment NPD
• Multicare Health System

  • Diagnostic Radiology Physician
  • Tacoma, WA
  • NPI 1285121442
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1962067215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17700 SE 272ND ST",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424951",
            "telephone_number": "253-372-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 SE 272ND ST",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424951",
            "telephone_number": "253-372-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSHAZZLY",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP61279697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob L. Eaton, LMP
• Melissa Sue Edwards, LMP
• Leta Kaye Eilers, MA00024665
• Michele N Elder, PHARMD
• Elizabeth a Warner MD Inc PS
• Eye Doctors Northwest PLLC
• Chisom Ezenwoye, PHARM. D
• Sophia Farkas
• Deidre Louise Feeney, M.D.
• Daniel Frank Fernandez, ATC

• Pediatrics Physician in Covington, WA
• Providers in Covington, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.