HESHAM MOHAMED ELGOUHARI M.D.
NPI 1104096726
Internal Medicine - Hepatology in Denison, TX

Active since March 11, 2008PECOS EnrolledAccepts Medicare Assignment
16.3/100
CMS Quality Rating
4616 S US HIGHWAY 75 STE 203, DENISON, TX 75020(903) 462-6310(903) 462-6311 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Mar 1, 2018 (2 updates tracked since 2018).

About Hesham Mohamed Elgouhari M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HESHAM MOHAMED ELGOUHARI M.D. (NPI 1104096726) is an individual hepatology provider in Denison, Texas, licensed in South Dakota (7199) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS, is affiliated with Alliancehealth Durant, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104096726
Entity TypeIndividualMale
Primary Taxonomy207RI0008X
Provider Legal NameHESHAM MOHAMED ELGOUHARICredential: M.D.
Location Address4616 S US HIGHWAY 75 STE 203Denison, TX 75020-4582
Mailing Address4616 S Us Highway 75 Ste 203Denison, TX 75020-4582 · (903) 462-6310 · Fax (903) 462-6311
Fax(903) 462-6311
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateMarch 11, 2008
Last NPPES UpdateMay 1, 20252 updates tracked since enumeration
NPPES CertifiedMay 1, 2025
NPI 1104096726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · HepatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0008X
Licenses Licensed in SD · 7199 Licensed in OH · 57.011317
Definition
The discipline of Hepatology encompasses the structure, function, and diseases of the liver and biliary tract. The American Board of Internal Medicine considers Hepatology part of the subspecialty of gastroenterology. Physicians who identify themselves as Hepatologists usually, but not always, have been trained in gastrointestinal programs.
Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X · License 57.011317 (OH)
Also ListedInternal Medicine · Transplant HepatologyTaxonomy 207RT0003X · License 57.011317 (OH)
4616 S US HIGHWAY 75 STE 203, Denison, TX 75020

Secondary Practice Locations 2

Location 11001 E. 21st St., Ste. 303Sioux Falls, SD 57105-1017 · Phone (605) 322-8535 · Fax (605) 322-8536
Location 25012 S US Highway 75 Ste 220Denison, TX 75020-4598 · Phone (903) 416-6110 · Fax (903) 416-6111

Other Identifiers 2

Medicaid6005870SD
Other256150Midland's Choice

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Hesham Mohamed Elgouhari M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547334989
PECOS Enrollment IDI20180410000824
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
1,356 services196 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,004 services467 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
261 services153 patients
Ultrasound scan of organ tissue for measuring elasticity 76981
An ultrasound scan of organ tissue measures elasticity, or flexibility. This non-invasive procedure uses sound waves to create images of the inside of your body. It helps in assessing the health of various organs by detecting changes in their stiffness or softness.
222 services209 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
219 services142 patients
Administration and interpretation of patient-focused health risk assessment 96160
This procedure involves a detailed evaluation of your health to identify potential risks. It includes analyzing your medical history, lifestyle habits, and family health history. The results are interpreted to provide a personalized plan to improve your health and prevent future issues.
182 services178 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Alliancehealth Durant

Acute Care Hospitals · Durant, OK
1/5 CMS rating
OwnershipProprietary
CMS Certification Number370014
Location1800 University BoulevardDurant, OK 74702 · Bryan County
Emergency services Birthing friendly
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number450044
Location6201 Harry Hines BlvdDallas, TX 75390 · Dallas County
Emergency services Birthing friendly

North Texas Medical Center

Acute Care Hospitals · Gainesville, TX
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450090
Location1900 Hospital BlvdGainesville, TX 76240 · Cooke County
Emergency services Birthing friendly

Texoma Medical Center

Acute Care Hospitals · Denison, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450324
Location5016 S Us Highway 75Denison, TX 75020 · Grayson County
Emergency services Birthing friendly

Tmc- Bonham Hospital

Critical Access Hospitals · Bonham, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451370
Location504 Lipscomb StreetBonham, TX 75418 · Fannin County
Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

16.3/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost54.35

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
4616 S US HIGHWAY 75 STE 203
DENISON, TX 75020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hesham Elgouhari's NPI number?

The NPI number for Hesham Elgouhari is 1104096726. It was assigned to this individual provider in the NPPES registry on March 11, 2008.

Where is Hesham Elgouhari located?

Hesham Elgouhari practices at 4616 S Us Highway 75 Ste 203, Denison, TX 75020. The listed phone number is (903) 462-6310.

What is Hesham Elgouhari's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hepatology, with taxonomy code 207RI0008X.

Is Hesham Elgouhari enrolled in Medicare?

Yes. Hesham Elgouhari is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Hesham Elgouhari accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Louisiana Healthcare Connections and 6 other insurers list Hesham Elgouhari as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Hesham Elgouhari affiliated with any hospitals?

According to CMS data, Hesham Elgouhari is affiliated with Alliancehealth Durant, Ut Southwestern University Hospital - William P. Clements Jr., North Texas Medical Center, Texoma Medical Center and Tmc- Bonham Hospital.

When was this NPI record last updated?

The NPPES record for Hesham Elgouhari was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.