Individual provider Active NPI

Mohammed Ali Mohammed Al-Amoodi

  • Interventional Cardiology Physician
  • Montgomery, OH
National Provider Identifier
1083866149
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35.136825 Issued in OH
Practice address
10506 Montgomery Rd Ste 300a
Montgomery, OH 45242-4400
Phone
(513) 246-2400
Fax
(513) 246-4050
NPI assigned
Oct 21, 2008
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2008028015 MO
Interventional Cardiology Physician 207RI0011X 48547 AZ
Interventional Cardiology Physician 207RI0011X 35.136825 OH Primary

Addresses

Primary practice location

10506 Montgomery Rd Ste 300a
Montgomery, OH 45242-4400

Mailing address

6875 W 51St Ter
Apt. 2B
Mission, KS 66202-1558
Phone (913) 271-7328

Other practice location 1

6875 W 51st Ter
Apt. 2b
Mission, KS 66202-1558
Phone (913) 271-7328

Other practice location 2

1707 W Saint Marys Rd Ste 101
Tucson, AZ 85745-2612
Phone (520) 622-5912

Other practice location 3

1951 W 25th St Ste F
Yuma, AZ 85364-6924
Phone (928) 336-1675

Other identifiers 1

IdentifierTypeStateIssuer
2565399MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OH, NV3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141022000043 AZ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4981825668 Reassigns benefits to 2 organizations
I20210909003629 OH Practitioner - Interventional Cardiology 4981825668 Reassigns benefits to 2 organizations
I20250410001956 NV Practitioner - Interventional CardiologyPractitioner - Internal Medicine 4981825668 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008028015MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Aug 30, 2021 Accepting new patients
Yuma Regional Medical Center CurrentSince Dec 3, 2017 Accepting new patients
Saint Marys Urgent Care LLC Current Accepting new patients
Trihealth G LLC Internal Medicine CurrentSince Aug 30, 2021 Accepting new patients
Young Hearts of Yuma, Inc CurrentSince Aug 1, 2014 Accepting new patients
Saint Mary's Medical Group Inc CurrentSince Apr 1, 2025 Accepting new patients
Saint Marys Medical Group Inc. Cardiovascular Disease CurrentSince Apr 1, 2025 Accepting new patients
Yuma Regional Medical Center Internal Medicine CurrentSince Dec 3, 2017 Accepting new patients
Trihealth H LLC Cardiovascular Disease CurrentSince Jan 1, 2022 Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1951 W 25th St
Ste F
Yuma, AZ 85364
Phone (928) 314-4800

2051 W 25th St
Ste A
Yuma, AZ 85364
Phone (928) 317-1119

2051 W 25th St
Ste Ab
Yuma, AZ 85364

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

2500 S 8th Ave
Ste 200
Yuma, AZ 85364
Phone (928) 336-7095

1801 W Olympic Blvd
#1461
Pasadena, CA 91199

18653 Wedge Pkwy
Ste 110
Reno, NV 89511
Phone (775) 352-7201

411 W 6th St
Reno, NV 89503
Phone (775) 770-3209

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

10506 Montgomery Rd
Ste 300A
Montgomery, OH 45242

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2204/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: malamoodi345844@direct.trihealth.com
  • Direct secure messaging: malamoodi405624@direct.stlukeshealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1083866149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6875 W 51ST TER",
            "address_2": "APT. 2B",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662021558",
            "telephone_number": "913-271-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506 MONTGOMERY RD STE 300A",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424400",
            "telephone_number": "513-246-2400",
            "fax_number": "513-246-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6875 W 51st Ter",
            "address_2": "Apt. 2b",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "KS",
            "postal_code": "662021558",
            "country_code": "US",
            "telephone_number": "913-271-7328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1707 W Saint Marys Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857452612",
            "country_code": "US",
            "telephone_number": "520-622-5912",
            "fax_number": "520-396-1375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1951 W 25th St Ste F",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853646924",
            "country_code": "US",
            "telephone_number": "928-336-1675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-AMOODI",
        "first_name": "MOHAMMED",
        "middle_name": "ALI MOHAMMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2008028015",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "48547",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35.136825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2565399",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.