Organization Active NPI

Osama Elshazly MD PA

  • Internal Medicine Physician
  • Panama City, FL
National Provider Identifier
1962514299
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME71008 Issued in FL
Legal business name
OSAMA ELSHAZLY MD PA
Practice address
2202 State Ave
Suite 102
Panama City, FL 32405-7601
Phone
(850) 785-0085
Fax
(850) 785-0558
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Osama A Elshazly, M.D.NPI 1407822877
Title
President
Phone
(850) 785-0085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME71008 FL Primary

Addresses

Primary practice location

2202 State Ave
Suite 102
Panama City, FL 32405-7601

Mailing address

2202 State Ave
Suite 102
Panama City, FL 32405-7601
Phone (850) 785-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070404000307 FL Part B Supplier - Clinic/Group Practice 5294839098 Receives reassigned benefits from 2 practitioners
Practice locations: Panama City, FL

National Provider Directory

National Provider Directory

Locations

2316 W 23rd St
Ste A
Panama City, FL 32405
Phone (850) 785-0085

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1962514299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE",
            "address_2": "SUITE 102",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057601",
            "telephone_number": "850-785-0085",
            "fax_number": "850-785-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE",
            "address_2": "SUITE 102",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057601",
            "telephone_number": "850-785-0085",
            "fax_number": "850-785-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSAMA ELSHAZLY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "ELSHAZLY",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-785-0085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.