NPIMap

Individual provider Active NPI

Mohamed E Eldaly, M.D.

  • Hematology & Oncology Physician
  • Turlock, CA
National Provider Identifier
1962501718
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
C52285 Issued in CA
Practice address
880 E Tuolumne Rd
103
Turlock, CA 95382-1548
Phone
(209) 669-8300
Fax
(209) 669-9300
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 75069 MA
Hematology & Oncology Physician 207RH0003X C52285 CA Primary

Addresses

Primary practice location

880 E Tuolumne Rd
103
Turlock, CA 95382-1548

Mailing address

6121 N Thesta St
204
Fresno, CA 93710-8603
Phone (559) 438-7390

Other identifiers 3

IdentifierTypeStateIssuer
00C522850MedicaidCA
00C522850OtherCABLUE SHIELD
GR0103970MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070220000655 CA Practitioner - Medical OncologyPractitioner - Hematology/OncologyPractitioner - Internal Medicine 0648211896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology/Oncology, Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Physician PartnersGroup PAC ID 0941465322, 130 clinicians

Practice addresses (Care Compare)

880 E Tuolumne Rd
Suite 103
Turlock, CA 95382-1549
Phone (209) 250-5320

Hospital & facility affiliations

  • Covenant Care at Home Home health agency, Turlock, CA, CCN 057571
  • Careone Home Health and Hospice, Inc Home health agency, Salida, CA, CCN 059401
  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179
  • Memorial Medical Center Hospital, Modesto, CA, CCN 050557
  • Doctors Medical Center Hospital, Modesto, CA, CCN 050464
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441
  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
64.37
Promoting interoperability
100
Improvement activities
40
Cost
72.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151875MAMDInternal Medicine Physician
75069MAMDInternal Medicine Physician
C52285CAMDHematology & Oncology Physician

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
First Choice Physician Partners Current Accepting new patients
First Choice Physician Partners CurrentSince Sep 1, 2016 Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients
Baystate Affiliated Practice Organization Internal Medicine Past Accepting new patients

Locations

1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839

1541 Florida Ave
Modesto, CA 95350
Phone (209) 214-7049

880 E Tuolumne Rd
Ste 101
Turlock, CA 95382
Phone (209) 664-2434

880 E Tuolumne Rd
Ste 103
Turlock, CA 95382
Phone (209) 250-5320

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

880 E Tuolumne Rd
Ste 201
Turlock, CA 95382
Phone (209) 632-2960

2121 Colorado Ave
Ste C
Turlock, CA 95382
Phone (209) 644-5175

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1962501718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST",
            "address_2": "204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108603",
            "telephone_number": "559-438-7390",
            "fax_number": "559-438-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 E TUOLUMNE RD",
            "address_2": "103",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953821548",
            "telephone_number": "209-669-8300",
            "fax_number": "209-669-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDALY",
        "first_name": "MOHAMED",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "75069",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "C52285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C522850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C522850",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.