Individual provider Active NPI

Mohammed Mobin Ahmed, M.D.

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1013335876
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME135869 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone
(904) 953-2000
NPI assigned
Mar 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME135869 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200708003438 FL Practitioner - Diagnostic Radiology 6507113099 Reassigns benefits to 2 organizations
I20210608000854 WI Practitioner - Diagnostic Radiology 6507113099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohri LLCGroup PAC ID 4981912169, 130 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

398 E Altamonte Dr
Altamonte Springs, FL 32701-4402
Phone (407) 331-9355

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032
  • Orlando Health Melbourne Hospital Hospital, Melbourne, FL, CCN 100291

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME135869FLMDDiagnostic Radiology Physician

Practice roles (8 of 9)

OrganizationSpecialtyStatusNew patients
Ohri, LLC CurrentSince Aug 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2023 Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Jul 26, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2023 Accepting new patients
Ohi West Medical Group, LLC Diagnostic Radiology CurrentSince Nov 2, 2023 Accepting new patients
Ohri, LLC CurrentSince Aug 1, 2023 Accepting new patients
Ohri, LLC Diagnostic Radiology Current Accepting new patients
Precision Radiology - Illinois LTD CurrentSince Feb 1, 2023 Accepting new patients

Locations

398 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 331-3955

52 Underwood St
#153
Orlando, FL 32806
Phone (321) 841-2558

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

10945 N Port Washington Rd
Ste 201
Thiensville, WI 53092
Phone (262) 478-0301

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

Networks

  • Freedom Health HMO Network

Organizations & group practices 8

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 6

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": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1013335876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MOHAMMED",
        "middle_name": "MOBIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-30",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME135869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.