NPIMap

Individual provider Active NPI

Mohamed Abdel Khalek, M.D

  • Internal Medicine Physician
  • Roseburg, OR
National Provider Identifier
1972687390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301075950 Issued in MI
Practice address
913 NW Garden Valley Blvd
Roseburg, OR 97470-6523
Phone
(541) 440-1000
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301075950 MI Primary

Addresses

Primary practice location

913 NW Garden Valley Blvd
Roseburg, OR 97470-6523

Mailing address

2429 SE Chinaberry Ave
Roseburg, OR 97470-3852
Phone (541) 672-3902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20071116000002 OH Practitioner - Internal Medicine 4082702535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Physician Services IncGroup PAC ID 6002172467, 5 clinicians

Practice addresses (Care Compare)

4627 Brookside Rd
Ottawa Hills, OH 43615-2207
Phone (313) 283-7211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
26.86 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
89.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Pioneer Physician Services, Inc. CurrentSince Oct 8, 2017 Accepting new patients
Regency Hospital of Toledo, LLC Past Accepting new patients
Encompass Health Rehabilitation Hospital of Toledo, LLC Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1865 Countryside Dr
Fremont, OH 43420
Phone (248) 660-1200

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

5220 Alexis Rd
Sylvania, OH 43560
Phone (419) 318-5700

4647 Monroe St
Toledo, OH 43623
Phone (567) 290-3500

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-5600

Organizations & group practices 4

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 9

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972687390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 SE CHINABERRY AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703852",
            "telephone_number": "541-672-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974706523",
            "telephone_number": "541-440-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDEL KHALEK",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301075950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.