NPIMap

Individual provider Active NPI

Mouhanna Khaled Mahmoud Abu Ghanimeh, M.D.

  • Gastroenterology Physician
  • Sioux Falls, SD
National Provider Identifier
1962812982
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
12467 Issued in SD
Practice address
1205 S Grange Ave
Sioux Falls, SD 57105-0407
Phone
(605) 328-6585
NPI assigned
Apr 29, 2014
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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 2014014710 MO
Gastroenterology Physician 207RG0100X 12467 SD Primary

Addresses

Primary practice location

1205 S Grange Ave
Sioux Falls, SD 57105-0407

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

2301 Holmes Street
Truman Medical Center
Kansas City, MO 64108
Phone (816) 404-4175

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mabughanimeh17222496@direct.sanfordhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20211022002024 SD Practitioner - Gastroenterology 2163725128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy79
Upper gastrointestinal (GI) endoscopy for acid reflux268

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Internal Medicine CurrentSince Aug 12, 2021 Accepting new patients
Sanford Clinic CurrentSince Jul 26, 2021 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic Gastroenterology CurrentSince Jul 26, 2021 Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Interoperability endpoints

  • Direct secure messaging: mabughanimeh17222496@direct.sanfordhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1962812982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S GRANGE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050407",
            "telephone_number": "605-328-6585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes Street",
            "address_2": "Truman Medical Center",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "64108",
            "country_code": "US",
            "telephone_number": "816-404-4175",
            "fax_number": "816-404-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABU GHANIMEH",
        "first_name": "MOUHANNA",
        "middle_name": "KHALED MAHMOUD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014014710",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SD",
            "license": "12467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mabughanimeh17222496@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1205 S Grange Ave",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571050407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.