NPIMap

Individual provider Active NPI

Mohamad A Sobh, D.O., RPH.

  • Interventional Cardiology Physician
  • Dearborn, MI
National Provider Identifier
1003030685
Registry record updated Aug 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
5101016232 Issued in MI
Practice address
1611 Monroe St
Dearborn, MI 48124-2912
Phone
(313) 278-7100
Fax
(313) 562-2216
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302031496 MI
Cardiovascular Disease Physician 207RC0000X 5101016232 MI
Internal Medicine Physician 207R00000X 5101016232 MI
Vascular Surgery Physician 2086S0129X 5101016232 MI
Nuclear Cardiology Physician 207UN0901X 5101016232 MI
Diagnostic Ultrasound Physician 2085U0001X 5101016232 MI
Interventional Cardiology Physician 207RI0011X 5101016232 MI Primary

Addresses

Primary practice location

1611 Monroe St
Dearborn, MI 48124-2912

Mailing address

1611 Monroe St
Dearborn, MI 48124-2912
Phone (313) 278-7100

Other identifiers 1

IdentifierTypeStateIssuer
1003030685MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121003000331 MI Practitioner - Cardiovascular Disease (Cardiology) 4486803657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ma Sobh DO PLCGroup PAC ID 4385876689, 4 clinicians

Practice addresses (Care Compare)

1611 Monroe St
Dearborn, MI 48124-2912
Phone (313) 586-7525

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Garden City Hospital Hospital, Garden City, MI, CCN 230244
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score
40.61 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
82.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20
Pacemaker insertion or repair13
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302031496MIMDPharmacist
5101016232MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ma Sobh DO PLC Cardiovascular Disease CurrentSince Apr 11, 2014 Accepting new patients
Complete Health Systems Inc CurrentSince Jan 1, 2021 Accepting new patients
Fahs Surgical Services PLLC Past Accepting new patients

Locations

15400 Michigan Ave
Ste 3
Dearborn, MI 48126
Phone (313) 581-5600

904 Mason St
Dearborn, MI 48124
Phone (313) 353-8779

1611 Monroe St
Dearborn, MI 48124
Phone (313) 254-4039

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIGBDA/Endpoint/EIGBDA
  • Direct secure messaging: msobh@direct.dmc.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408147200000",
    "number": "1003030685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242912",
            "telephone_number": "313-278-7100",
            "fax_number": "313-562-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242912",
            "telephone_number": "313-278-7100",
            "fax_number": "313-562-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBH",
        "first_name": "MOHAMAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O., RPH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302031496",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101016232",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101016232",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "5101016232",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MI",
            "license": "5101016232",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MI",
            "license": "5101016232",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "5101016232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003030685",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.