1. Home
  2. Directory
  3. Louisiana
  4. Shreveport
  5. Pediatrics
  6. NPI Profile

NIDAL A. MAHGOUB MD
NPI 1215014154
Pediatrics - Pediatric Hematology-Oncology in Shreveport, LA

Active since October 31, 2006PECOS Enrolled
1541 KINGS HWY, SHREVEPORT, LA 71103(318) 626-0000(318) 629-4833 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nidal A. Mahgoub Md NPPES

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

NIDAL A. MAHGOUB MD (NPI 1215014154) is an individual pediatric hematology-oncology provider in Shreveport, Louisiana, licensed in Louisiana (342048) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Santa Clara.

NPPES Registry Identity

NPI1215014154
Entity TypeIndividualFemale
Primary Taxonomy2080P0207X
Provider Legal NameNIDAL A. MAHGOUBCredential: MD
Location Address1541 KINGS HWYShreveport, LA 71103-4228
Mailing Address1541 Kings HwyShreveport, LA 71103-4228
Phone(318) 626-0000
Fax(318) 629-4833
Sole ProprietorNo
Enumeration DateOctober 31, 2006
Last NPPES UpdateAugust 8, 2024
NPPES CertifiedAugust 8, 2024
✔ NPI 1215014154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
Licenses✔ Licensed in LA · 342048✔ Licensed in CA · A49252
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
Also ListedPediatricsTaxonomy 208000000X · License 342048 (LA)
1541 KINGS HWY, Shreveport, LA 71103
Open in Google Maps ↗

Secondary Practice Location 1

Location 1710 Lawrence ExpySanta Clara, CA 95051-5173 · Phone (408) 851-1000

Other Identifiers 1

Medicaid00A492520CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nidal A. Mahgoub Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

PRATIK AGRAWAL
Internal Medicine (Cardiovascular Disease)
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
SHAHEENA ANENE
Pediatrics
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
UDAY KUMAR CHALWADI
Pediatrics (Pediatric Pulmonology)
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
AYA MOUHAFFEL MD
Anesthesiology
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
JENNIFER B CYPHER PA-C
Physician Assistant (Medical)
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
STEVEN R BAILEY MD
Internal Medicine (Interventional Cardiology)
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
DR. RUSSELL SCOTT ANDERSON MD
Radiology (Radiation Oncology)
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000
PEIMIN ZHU M.D.
Psychiatry & Neurology (Neurology)
1541 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0000

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 Nidal Mahgoub's NPI number?

The NPI number for Nidal Mahgoub is 1215014154. It was assigned to this individual provider in the NPPES registry on October 31, 2006.

Where is Nidal Mahgoub located?

Nidal Mahgoub practices at 1541 Kings Hwy, Shreveport, LA 71103. The listed phone number is (318) 626-0000.

What is Nidal Mahgoub's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Nidal Mahgoub enrolled in Medicare?

Yes. Nidal Mahgoub is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nidal Mahgoub was last updated on August 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.