Mouhanna Khaled Mahmoud Abu Ghanimeh, M.D.
Individual provider Active NPI Gastroenterology Physician · Sioux Falls, SD
NPI 1962812982 · NPPES record last updated Apr 18, 2022
Key facts
- NPI
- 1962812982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 12467 (SD)
- Practice address
- 1205 S Grange Ave
Sioux Falls, SD 57105-0407 - Phone
- (605) 328-6585
- NPI assigned
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Gastroenterology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sanford Medical Center
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
- Sanford Usd Medical Center
- Sanford Vermillion Medical Center
- Orange City Area Health System
- Sanford Sheldon Medical Center
- Sanford Worthington Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 79 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 268 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211022002024 | SD | Practitioner - Gastroenterology | 2163725128 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12467 | SD | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Clinic | Gastroenterology | Current |
Accepting new patients |
| Sanford Clinic | Current |
Accepting new patients | |
| Sanford Clinic | Current | Accepting new patients | |
| Sanford Medical Center | Internal Medicine | Current |
Accepting new patients |
| Sanford Clinic | Past | Accepting new patients |
Locations
525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000
4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000
1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300
Interoperability endpoints
- mabughanimeh17222496@direct.sanfordhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2014014710 | MO | |
| Gastroenterology Physician | 207RG0100X | 12467 | SD | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mabughanimeh17222496@direct.sanfordhealth.org | Direct |
Other providers in Sioux Falls, SD
- Josiah Abraham
- Michelle Lynn Abraham
- Beth Abrahamson
- Jessica Marie Abrahamson
- Summer Abrego
- Emad M a Abu Sitta
- Kalee Abu-Ghazaleh
- Samir Zaki Abu-Ghazaleh
- Unknown Abubakar
- Accelerate
All providers in Sioux Falls, SD · Gastroenterology Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.