Individual provider Active NPI

Muhammad Rehan, M.D.

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1063583680
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042405 Issued in GA
Practice address
640 1St St
Macon, GA 31201-2805
Phone
(478) 745-7696
Fax
(478) 745-6440
NPI assigned
Nov 13, 2006
Last updated
Nov 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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 042405 GA Primary

Addresses

Primary practice location

640 1St St
Macon, GA 31201-2805

Mailing address

640 1St St
Macon, GA 31201-2805
Phone (478) 745-7696

Other identifiers 5

IdentifierTypeStateIssuer
000758172NMedicaidGA
110238633OtherGARAIL ROAD MEDICARE
52597384 011OtherGABCBS PROVIDER #
000758172NOtherGAPEACH STATE PROVIDER #
319589OtherGAWELL CARE PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20041215000307 GA Practitioner - Internal Medicine 8123085784 Practice locations: Macon, GA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

640 1St St
Macon, GA 31201-2805
Phone (478) 745-7696

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042405GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Internal Medicine, LLC Internal Medicine CurrentSince Jan 1, 1990 Accepting new patients
Inpatient Consultants of Georgia, Inc Internal Medicine Past Accepting new patients
Middle Georgia Internal Medicine & Kidney Diseases PastSince Mar 1, 2012 Accepting new patients
Middle Ga Nephrology Internal Medicine Past Accepting new patients

Locations

640 1st St
Macon, GA 31201
Phone (478) 745-7696

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGGGAA/Endpoint/AGGGAA

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1063583680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012805",
            "telephone_number": "478-745-7696",
            "fax_number": "478-745-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012805",
            "telephone_number": "478-745-7696",
            "fax_number": "478-745-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHAN",
        "first_name": "MUHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "042405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000758172N",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110238633",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "52597384 011",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE PROVIDER #",
            "identifier": "000758172N",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELL CARE PROVIDER #",
            "identifier": "319589",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.