Individual provider Active NPI

Mohsen G Gam, M.D.

  • Internal Medicine Physician
  • Scarsdale, NY
National Provider Identifier
1063552552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
112230 Issued in NY
Practice address
50 Popham Rd
Scarsdale, NY 10583-4253
Phone
(914) 723-1989
Fax
(914) 723-1330
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 112230 NY Primary

Addresses

Primary practice location

50 Popham Rd
Scarsdale, NY 10583-4253

Mailing address

50 Popham Rd
Scarsdale, NY 10583-4253
Phone (914) 723-1989

Other identifiers 1

IdentifierTypeStateIssuer
00202942MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20210426000482 NY Order and Referring Only - General PracticePractitioner - General Practice 7719016146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112230NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063552552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 POPHAM RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834253",
            "telephone_number": "914-723-1989",
            "fax_number": "914-723-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 POPHAM RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834253",
            "telephone_number": "914-723-1989",
            "fax_number": "914-723-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAM",
        "first_name": "MOHSEN",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "112230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00202942",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.