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

Q: 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.

Q: What is Hesham Elgouhari's specialty?

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

Q: 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 17 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.

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: October 25, 2026.

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

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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

Phone(903) 462-6310

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

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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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Hesham Elgouhari reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Texoma Liver Center PLLC

Same address

Internal Medicine

4616 S US HIGHWAY 75 STE 203
Denison, TX 75020

Reassigned Medicare billing, Texas enrollment
4 clinicians in this Medicare group

NPI 1174035117 (903) 462-6310

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

169 services71 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

136 services136 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

100 services83 patients

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes G0396

This service involves a structured evaluation of your alcohol or substance use habits. It identifies potential issues and provides brief counseling to help modify harmful behaviors. It's a short, 15-30 minute process, focused on promoting healthier choices.

87 services87 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

34 services33 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 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

Ut Southwestern University Hospital - William P. Clements Jr.

Acute Care Hospitals · Dallas, TX

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

Paris Regional Medical Center

Acute Care Hospitals · Paris, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450196

Location865 Deshong DrParis, TX 75460 · Lamar 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

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

Quality

Improvement Activities

Cost

54.35

Other Providers at the Same Location NPPES 3

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

RAFAY LATIF M.D / MHA

Internal Medicine (Geriatric Medicine)

4616 S US HIGHWAY 75 STE 203
DENISON, TX 75020

Grayson County (469) 886-8537

TEXOMA LIVER CENTER PLLC

Internal Medicine

4616 S US HIGHWAY 75 STE 203
DENISON, TX 75020

Grayson County (903) 462-6310

CONCEPT HEALTH CLINIC LLC

Internal Medicine (Geriatric Medicine)

4616 S US HIGHWAY 75 STE 203
DENISON, TX 75020

Grayson County (469) 886-8537

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.

Which organization bills Medicare for Hesham Elgouhari's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hesham Elgouhari reassigns Medicare benefits to Texoma Liver Center PLLC (Denison, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hesham Elgouhari's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hesham Elgouhari accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Sunflower Health Plan and 5 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, Paris Regional Medical Center and Texoma Medical Center.

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 17 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.