Mouhsen H Alhakeem, MD
Individual provider Active NPI Critical Care Medicine (Internal Medicine) Physician · Mesa, AZ
NPI 1003934175 · NPPES record last updated Sep 22, 2020
Key facts
- NPI
- 1003934175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician 207RC0200X
- License
- 48983 (AZ)
- Practice address
- 1400 S Dobson Road
Attn Amanda Gump/Hospitalist
Mesa, AZ 85202-4707 - Phone
- (480) 412-6788
- Fax
- (480) 412-6848
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Hospital Based Physicians Arizona LLC
Practice addresses (Care Compare)
1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone (480) 412-3000
Hospital & facility affiliations
- Banner Desert Medical Center
- Banner Ocotillo Medical Center
- Banner Ironwood Medical Center
- Banner Goldfield Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160308000361 | AZ | Practitioner - Pulmonary Disease | 9638242514 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48983 | AZ | MD | Critical Care Medicine (Internal Medicine) Physician |
| 57181-020 | WI | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Hospital Based Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Hospital Based Physicians Arizona LLC | Current |
Accepting new patients | |
| Banner Hospital Based Physicians Arizona LLC | Critical Care Medicine | Current |
Accepting new patients |
| Banner Desert Medical Center | Past | Accepting new patients |
Locations
1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000
1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000
1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 48983 | AZ | |
| Pulmonary Disease Physician | 207RP1001X | 57181-020 | WI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 48983 | AZ | Yes |
Addresses
Primary practice location
1400 S Dobson Road
Attn Amanda Gump/Hospitalist
Mesa, AZ 85202-4707
Mailing address
1400 S Dobson Road
Attn Amanda Gump/Hospitalist
Mesa, AZ 85202-4707
Phone (480) 412-6788
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61305 | Other | WI | DEAN HEALTH INSURANCE |
Other providers in Mesa, AZ
- Yanelys Alfonso
- James Abraham Alford II
- Eric Christian Alfrey
- Stephen Alger
- Ayman Shabib Alhadheri
- Manal Alhakim
- Suhail Alhreish
- Arefeh Ali Cheshmeh Alaei
- Ali H. Nia, D.M.D., P.C.
- Erum Ali
All providers in Mesa, AZ · Critical Care Medicine (Internal Medicine) Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.