Active NPI
Muzammal Ahmed, DO
- Family Medicine Physician
- Urbana, IL
National Provider Identifier
1073006805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036157485
- Practice address
- 611 W Park St
Urbana, IL 61801 - Phone
- (217) 383-3311
- NPI assigned
- Jun 6, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125072815 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 125072815 | IL | |
| Family Medicine Physician | 207Q00000X | 036157485 | IL | Primary |
Addresses
Primary practice location
611 W Park St
Urbana, IL 61801
Mailing address
611 W Park St
Fapc
Urbana, IL 61801-2529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210824002605 | IL | Practitioner - Family Practice | 9739431370 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carle Health Care Incorporated
Practice addresses (Care Compare)
1002 Medical Ctr Dr
Monticello, IL 61856-2116
Phone (217) 762-2518
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Home Care
- Carle Foundation Hospital
- Kirby Medical Center
- Decatur Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036157485 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Family Medicine | Current | Accepting new patients |
| Carle Health Care Incorporated | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
1002 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-2518
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- mahmeddo259115@carlehiedirect.net
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Family Medicine, IL
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1235452996
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Champaign, IL
- NPI 1891780615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1073006805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"address_2": "FAPC",
"city": "URBANA",
"state": "IL",
"postal_code": "618012529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "61801",
"telephone_number": "217-383-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "MUZAMMAL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-06",
"last_updated": "2022-11-14",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125072815",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "125072815",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036157485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.