OMAR METWALLY MD
NPI 1104243336
Internal Medicine in Ketchikan, AK

Q: What is Omar Metwally's NPI number?

The NPI number for Omar Metwally is 1104243336. It was assigned to this individual provider in the NPPES registry on March 26, 2014.

Q: What is Omar Metwally's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Omar Metwally was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 26, 2014PECOS Enrolled

3100 TONGASS AVE, KETCHIKAN, AK 99901(907) 228-8300 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 17, 2025, Jun 4, 2019, Jul 15, 2016 (3 updates tracked since 2016).

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About Omar Metwally Md NPPES

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

OMAR METWALLY MD (NPI 1104243336) is an individual internal medicine provider in Ketchikan, Alaska, licensed in Alaska (226166) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Dearborn, and is a graduate of Michigan State University College Of Human Medicine (2013).

NPPES Registry Identity

NPI1104243336

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameOMAR METWALLYCredential: MD

Location Address3100 TONGASS AVEKetchikan, AK 99901-5746

Mailing Address24224 Joy Rd, Ste 101Redford, MI 48239-1215 · (510) 437-4141

Phone(907) 228-8300

Sole ProprietorNo

Medical School CMSMichigan State University College Of Human MedicineGraduated 2013

Enumeration DateMarch 26, 2014

Last NPPES UpdateSeptember 17, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2025

✔ NPI 1104243336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in AK · 226166✔ Licensed in CA · 138074✔ Licensed in MI · 4301114008

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3100 TONGASS AVE, Ketchikan, AK 99901

Open in Google Maps ↗

Other Identifiers 2

Other138074CA · Ca License

Other4301114008MI · Mi License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omar Metwally Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305114083

PECOS Enrollment IDI20190607001906

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 Reassignments

Medicare enrollment records show Omar Metwally reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Peacehealth

Same address

Critical Access

3100 TONGASS AVE
Ketchikan, AK 99901

Reassigned Medicare billing, Alaska enrollment
Also billed through NPI 1801965736 (Alaska)
133 clinicians in this Medicare group

NPI 1396705539 (907) 228-8300

Nabil Metwally MD PC

2,326 mi

Internal Medicine

24224 JOY RD, SUITE 101
Redford, MI 48239

Reassigned Medicare billing, Michigan enrollment
5 clinicians in this Medicare group

NPI 1922116128 (313) 565-6663

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

Hospital Affiliations CMS Care Compare 2

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

Beaumont Hospital - Dearborn

Acute Care Hospitals · Dearborn, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230020

Location18101 Oakwood BlvdDearborn, MI 48124 · Wayne County

Emergency services Birthing friendly

Corewell Health Wayne Hospital

Acute Care Hospitals · Wayne, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230142

Location33155 Annapolis AveWayne, MI 48184 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$168.20 typical visit price

range $71.33 – $222.64

Typical copayment $42.05 (range $17.83 – $55.66)

Most-billed visit code 99204

Established Patient

$128.73 typical visit price

range $21.84 – $181.48

Typical copayment $32.18 (range $5.46 – $45.37)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

UROLOGY NORTHWEST, PS

Urology

3100 TONGASS AVE, 3RD FLOOR VISITING CLINIC
KETCHIKAN, AK 99901

Ketchikan Gateway Borough (855) 881-5319

SCOTT MYERS KIRCHNER MD

Internal Medicine