Elisa Pratima Mohan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

10590 Issued in GA

Practice address

764 Pine St
Macon, GA 31201-2107

Phone

(478) 301-5824

NPI assigned

Apr 18, 2018

Last updated

Jun 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mdics at BWMC LLCGroup PAC ID 7315106184, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emohan967877@direct.umm.edu
• FHIR API: https://fhir4.healow.com/fhir/r4/JAGGAA

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

• Mdics at BWMC LLC

  • Hospitalist Physician
  • Glen Burnie, MD
  • NPI 1306131578
  Medicare reassignment Care Compare group NPD
• Central Georgia Pulmonary Associates, LLC

  • Pulmonary Disease Physician
  • Macon, GA
  • NPI 1669521902
  NPD (past)
• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  NPD (past)

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

• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  Care Compare affiliation

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1033606603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012107",
            "telephone_number": "478-301-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012107",
            "telephone_number": "478-301-5824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Hospital Drive, Building A, Suite 430",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31217",
            "country_code": "US",
            "telephone_number": "478-751-0480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "ELISA",
        "middle_name": "PRATIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "10590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Cherie Mize, APRN
• Tricia Marie Mizell, R.T. (R) (ARRT)
• MKM Therapy Services, LLC
• Lisa Lasseter Mobley, LMFT
• Tabra J. Mobley, RBT
• Palghat V Mohan, M.D
• Brandy Mohn, LCSW
• Khuzema Mohsin, MD
• Hillary Lee Moinipour, NP-C
• Charkela Jenea Gaston Molden, ED.S., LPC, NCC

• Internal Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.