Individual provider Active NPI

Denelle Mohammed, MD

  • Family Medicine Physician
  • Mt Pleasant, MI
National Provider Identifier
1073184701
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301510477 Issued in MI
Practice address
2790 Health Pkwy
Mount Pleasant, MI 48858-6934
Phone
(989) 953-5320
NPI assigned
Jul 4, 2021
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 4301510477 MI Primary

Addresses

Primary practice location

2790 Health Pkwy
Mount Pleasant, MI 48858-6934

Mailing address

2790 Health Pkwy
Mount Pleasant, MI 48858-6934

Other practice location 1

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240806002498 MI Practitioner - Family Practice 6901202530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Isabella Citizens for Health IncGroup PAC ID 9335386051, 12 clinicians

Practice addresses (Care Compare)

2790 Health Pkwy
Mount Pleasant, MI 48858-6934
Phone (989) 953-5320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301510477MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Isabella Citizens for Health, Inc. CurrentSince Sep 3, 2024 Accepting new patients
Isabella Citizens for Health Inc CurrentSince Sep 3, 2024 Accepting new patients
Isabella Citizens for Health Inc Current Accepting new patients

Locations

2790 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 779-5270

Interoperability endpoints

  • Direct secure messaging: denelle.mohammed.p1@direct.isabellahealth.nextgenshare.com
  • Direct secure messaging: dmohammed729700@direct.hfhs.org

Organizations & group practices 3

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 2

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": "1625356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1073184701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488586934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488586934",
            "telephone_number": "989-953-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "517-205-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "DENELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-04",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301510477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.