HANY M MAHFOUZ (MD) – Critical Care Medicine (Internal Medicine) Physician, NPI 1699890525
Critical Care Medicine (Internal Medicine) Physician
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for HANY M MAHFOUZ (MD)
12101 WOODCREST EXECUTIVE DR
SUITE 210
SAINT LOUIS, MO 631415047
Phone: (314) 317-0600
Fax: (314) 317-0606
Type: Mailing
12220 BLUE RIDGE EXT STE A
GRANDVIEW, MO 640301175
Phone: (816) 763-1755
Type: Location
12220 Blue Ridge Ext Ste A
Grandview, MO 640301175
Phone: (816) 763-1755
Type: Location
3501 Cranberry Blvd
Weston, WI 544765213
Phone: (715) 393-1000
Type: Location
6420 Clayton Rd
Saint Louis, MO 631171811
Phone: (314) 317-0600
Fax: (314) 317-0606
Type: Location
3400 MINISTRY PKWY
WESTON, WI 544765220
Phone: (715) 393-1000
Fax: (715) 393-1469
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-09-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090817000275 | I | Internal Medicine | WI | TBD |
| I20210928002524 | I | Pulmonary Disease | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63141)
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Group practice members
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