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DR. MAGED ADEL GHALI MD
NPI 1629404181
Internal Medicine - Gastroenterology in Jacksonville, FL

Active since September 16, 2013PECOS Enrolled
81.9/100
CMS Quality Rating
4555 EMERSON ST STE 300, JACKSONVILLE, FL 32207(904) 633-0797 Get Directions Write a Review

NPPES record last updated: November 19, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Maged Adel Ghali Md NPPES

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

DR. MAGED ADEL GHALI MD (NPI 1629404181) is an individual gastroenterology provider in Jacksonville, Florida, licensed in Minnesota (46985) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629404181
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. MAGED ADEL GHALICredential: MD
Location Address4555 EMERSON ST STE 300Jacksonville, FL 32207-4958
Mailing Address108 Bent Pine CtPonte Vedra Beach, FL 32082-2184
Phone(904) 633-0797
Sole ProprietorYes
Enumeration DateSeptember 16, 2013
Last NPPES UpdateNovember 19, 2018
✔ NPI 1629404181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in MN · 46985✔ Licensed in FL · ME136384
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
4555 EMERSON ST STE 300, Jacksonville, FL 32207
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Other Names 1

Other Name (5)Dr. Peter Ghali Md

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Maged Adel Ghali 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.

Areas of Expertise CMS Part B claims 7

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.

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.
23 services17 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
18 services13 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.
16 services16 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
11 services11 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
11 services11 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.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32207 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

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.

81.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.43
Promoting Interoperability100
Improvement Activities40
Cost59.59

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$4.92 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each A4410
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$6.26 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each A4427
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$2.69 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Maged Ghali's NPI number?

The NPI number for Maged Ghali is 1629404181. It was assigned to this individual provider in the NPPES registry on September 16, 2013. The provider is also known as Dr. Peter Ghali MD.

Where is Maged Ghali located?

Maged Ghali practices at 4555 Emerson St Ste 300, Jacksonville, FL 32207. The listed phone number is (904) 633-0797.

What is Maged Ghali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Maged Ghali enrolled in Medicare?

Yes. Maged Ghali is registered in the Medicare PECOS enrollment system.

What insurance does Maged Ghali accept?

Health plans from AvMed list Maged Ghali 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.

When was this NPI record last updated?

The NPPES record for Maged Ghali was last updated on November 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.