Organization Active NPI

Mohammad Afzal MD Internal Medicine LLC

  • Internal Medicine Physician
  • Somerset, KY
National Provider Identifier
1083805931
Registry record updated May 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MOHAMMAD AFZAL MD INTERNAL MEDICINE LLC
Practice address
110 Hardin LN Ste 2B
Somerset, KY 42503-3818
Phone
(606) 451-0312
NPI assigned
Aug 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2017

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

Authorized official

Name
Melissa Smith
Title
Office Manager
Phone
(606) 451-0312

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

110 Hardin LN Ste 2B
Somerset, KY 42503-3818

Mailing address

110 Hardin LN Ste 2B
Somerset, KY 42503-3818
Phone (606) 451-0312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070906000767 KY Part B Supplier - Clinic/Group Practice 6709979776 Receives reassigned benefits from 2 practitioners
Practice locations: Somerset, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D1068868Mohammad Afzal, MD Internal Medicine, LLC110 Hardin Lane #2-B, Somerset, KY 42503Certificate of waiverMay 21, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494892800000",
    "number": "1083805931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN STE 2B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-0312",
            "fax_number": "606-451-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN STE 2B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD AFZAL MD INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2017-05-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-451-0312"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.