IDRIS FATHI ALI AMGHAIAB MD
NPI 1962146472
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Q: What is Idris Ali Amghaiab's NPI number?

The NPI number for Idris Ali Amghaiab is 1962146472. It was assigned to this individual provider in the NPPES registry on April 21, 2022.

Q: What is Idris Ali Amghaiab's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 21, 2022PECOS Enrolled

49 JESSE HILL JR DR SE, ATLANTA, GA 30303(404) 778-7777 Get Directions Write a Review

NPPES record last updated: March 28, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 28, 2023, Apr 21, 2022 (2 updates tracked since 2022).

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About Idris Fathi Ali Amghaiab Md NPPES

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

IDRIS FATHI ALI AMGHAIAB MD (NPI 1962146472) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962146472

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameIDRIS FATHI ALI AMGHAIABCredential: MD

Location Address49 JESSE HILL JR DR SEAtlanta, GA 30303-3049

Mailing Address49 Jesse Hill Jr Dr SeAtlanta, GA 30303-3049 · (404) 778-7777

Phone(404) 778-7777

Sole ProprietorYes

Enumeration DateApril 21, 2022

Last NPPES UpdateMarch 28, 20232 updates tracked since enumeration

NPPES CertifiedMarch 28, 2023

✔ NPI 1962146472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

49 JESSE HILL JR DR SE, Atlanta, GA 30303

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Idris Fathi Ali Amghaiab 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.

NICHOLAS AUSTIN MD

Internal Medicine