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GHADA MOHAMED SAMI AHMED K ELSHIMY M.D.
NPI 1629453428
Internal Medicine - Endocrinology, Diabetes & Metabolism in Augusta, GA

Active since July 22, 2015PECOS EnrolledAccepts Medicare Assignment
77.82/100
CMS Quality Rating
1120 15TH ST # HB-5025, AUGUSTA, GA 30912(706) 721-2131(706) 721-6892 Get Directions Write a Review

NPPES record last updated: July 23, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 23, 2020, Jun 11, 2020, May 4, 2020 and 1 more (4 updates tracked since 2019).

About Ghada Mohamed Sami Ahmed K Elshimy M.d. NPPES

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

GHADA MOHAMED SAMI AHMED K ELSHIMY M.D. (NPI 1629453428) is an individual endocrinology, diabetes & metabolism provider in Augusta, Georgia, licensed in Georgia (84067) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS, is affiliated with Grady Memorial Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1629453428
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameGHADA MOHAMED SAMI AHMED K ELSHIMYCredential: M.D.
Location Address1120 15TH ST # HB-5025Augusta, GA 30912-0004
Mailing Address4626 N 16th St Apt 1667Phoenix, AZ 85016-5157
Phone(706) 721-2131
Fax(706) 721-6892
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 22, 2015
Last NPPES UpdateJuly 23, 20204 updates tracked since enumeration
NPPES CertifiedJuly 23, 2020
✔ NPI 1629453428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in GA · 84067
Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

1120 15TH ST # HB-5025, Augusta, GA 30912
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Ghada Mohamed Sami Ahmed K Elshimy 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 ID1355772286
PECOS Enrollment IDI20200511000330
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 4

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.
134 services102 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
41 services32 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
23 services12 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.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Grady Memorial Hospital

Acute Care Hospitals · Atlanta, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110079
Location80 Jesse Hill, Jr Drive SEAtlanta, GA 30303 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

77.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.04
Promoting Interoperability92
Improvement Activities40
Cost60.7

Referred Medical Equipment & Supplies CMS DME claims

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

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers40 claims40 services$189.30 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

SARA J HEALY M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1120 15TH ST # HB-5025
AUGUSTA, GA 30912
Richmond County (706) 721-2131
JUAN EUGENIO RIVERA-SALVA MD
Internal Medicine
1120 15TH ST # HB-5025
AUGUSTA, GA 30912
Richmond County (706) 721-2131

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 Ghada Elshimy's NPI number?

The NPI number for Ghada Elshimy is 1629453428. It was assigned to this individual provider in the NPPES registry on July 22, 2015.

Where is Ghada Elshimy located?

Ghada Elshimy practices at 1120 15th St # Hb-5025, Augusta, GA 30912. The listed phone number is (706) 721-2131.

What is Ghada Elshimy's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Ghada Elshimy enrolled in Medicare?

Yes. Ghada Elshimy 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 Ghada Elshimy accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Ghada Elshimy 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 Ghada Elshimy affiliated with any hospitals?

According to CMS data, Ghada Elshimy is affiliated with Grady Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Ghada Elshimy was last updated on July 23, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.