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  7. NPI Record 1679861389

DR. AMGAD MOHAMMED HALEEM AMIN M.D
Complete NPI Record 1679861389
Special Hospital in Boston, MA


Quality Rating: 76.47 out of 100 score

NPI Status: Active since July 14, 2011

Contact Information

55 FRUIT ST
BOSTON, MA
ZIP 02114
Phone: (617) 724-9338

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider Other Last Name
  9. Provider Other First Name
  10. Provider Other Name Prefix Text
  11. Provider Other Credential Text
  12. Provider Other Last Name Type Code
  13. Provider First Line Business Mailing Address
  14. Provider Business Mailing Address City Name
  15. Provider Business Mailing Address State Name
  16. Provider Business Mailing Address Postal Code
  17. Provider Business Mailing Address Country Code If outside U S
  18. Provider Business Mailing Address Telephone Number
  19. Provider Business Mailing Address Fax Number
  20. Provider First Line Business Practice Location Address
  21. Provider Business Practice Location Address City Name
  22. Provider Business Practice Location Address State Name
  23. Provider Business Practice Location Address Postal Code
  24. Provider Business Practice Location Address Country Code If outside U S
  25. Provider Business Practice Location Address Telephone Number
  26. Provider Enumeration Date
  27. Last Update Date
  28. Provider Gender Code
  29. Healthcare Provider Taxonomy Code 1
  30. Provider License Number 1
  31. Provider License Number State Code 1
  32. Healthcare Provider Primary Taxonomy Switch 1
  33. Healthcare Provider Taxonomy Code 2
  34. Provider License Number 2
  35. Provider License Number State Code 2
  36. Healthcare Provider Primary Taxonomy Switch 2
  37. Healthcare Provider Taxonomy Code 3
  38. Provider License Number 3
  39. Provider License Number State Code 3
  40. Healthcare Provider Primary Taxonomy Switch 3
  41. Is Sole Proprietor
  42. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1679861389. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1679861389
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: AMGAD
The first name of the provider, if the provider is an individual.
Provider Middle Name: MOHAMMED HALEEM
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: M.D
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name: HALEEM
Other last name by which the provider being identified is or has been known.
Provider Other First Name: AMGAD
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Name Prefix Text: DR.
The other name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Other Credential Text: M.D
The other abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name Type Code: 2
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 800 STANTON L YOUNG BLVD STE 3400
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: OKLAHOMA CITY
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: OK
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 731045018
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 4052714426
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 4052713074
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 55 FRUIT ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: BOSTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 021142621
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6177249338
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 7/14/2011
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Last Update Date: 2/12/2024
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Gender Code: M
The name of the organization provider. If the provider is an organization, this is the legal business name.
Healthcare Provider Taxonomy Code 1: 207X00000X
Other name by which the organization provider is or has been known.
Provider License Number 1: 1017457
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider License Number State Code 1: MA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 207XX0004X
Provider License Number 2: 1017457
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: MA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 284300000X
Provider License Number 3: PENDING
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider License Number State Code 3: NY
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Healthcare Provider Primary Taxonomy Switch 3: Y
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Is Sole Proprietor: Y
The city name in the location address of the provider being identified.
NPI Certification Date: 2/12/2024
The State code in the location of the provider being identified.