NPIMap

Individual provider Active NPI

Mohamed Elfedaly, M.D.

  • Surgery Physician
  • Amarillo, TX
National Provider Identifier
1972869964
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
T4514 Issued in TX
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 414-9558
Fax
(806) 354-5561
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 47265 TX
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X T4514 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 S Coulter St
Amarillo, TX 79106-1786
Phone (806) 414-9558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210514002274 TX Practitioner - General Surgery 5395154777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 S Coulter St
Amarillo, TX 79106-1786
Phone (806) 414-9800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T4514TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center CurrentSince May 17, 2021 Accepting new patients
Texas Tech University Health Sciences Center Amarillo Surgery CurrentSince May 17, 2021 Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Deaf Smith County Hospital District Current Accepting new patients
Deaf Smith County Hospital District CurrentSince Aug 1, 2021 Accepting new patients
Deaf Smith County Hospital District Past Accepting new patients
Texas Tech University Health Sciences Center Amarillo Surgery Past Accepting new patients
Texas Tech University Health Sciences Center El Paso Past Accepting new patients
Northwest Texas Healthcare System Inc Past Accepting new patients

Locations

1400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5585

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

540 W 15th St
Hereford, TX 79045
Phone (806) 364-2141

Interoperability endpoints

  • Direct secure messaging: mohamedelfedaly@ttuhsc.allscriptsdirect.net

Organizations & group practices 11

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 2

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1972869964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9558",
            "fax_number": "806-354-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELFEDALY",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "47265",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "T4514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.