Shish Ali Mohammad, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A190665 Issued in CA

Practice address

45124 10TH St W
Lancaster, CA 93534-2310

Phone

(562) 867-7999

NPI assigned

Jul 16, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 4)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: shish.mohammadmd.p1@direct.jwch.nextgenshare.com

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.

• JWCH Institute Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1407808058

  CA

  Medicare reassignment NPD
• JWCH Institute Inc

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1073209177
  NPD
• JWCH Institute, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lynwood, CA
  • NPI 1124182977
  NPD

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1093323974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "562-867-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45124 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45104 10th St W",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935342310",
            "country_code": "US",
            "telephone_number": "562-867-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMAD",
        "first_name": "SHISH",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A190665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moazzem H. Chowdhury
• Kevin A. Moccardini, MFC 50540
• Arlene Catherine Moeller
• Mohamed Z. Lameer, M.D.
• Osama Mohamed, M.D.
• Dustin Rakim Mohammed
• Tarek Mohana, O.D.
• Cynthia Natalie Mohd
• Marissa Yesenia Moisa Hernandez, ACSW
• Shahriar Mokrian, M.D.

• Pediatrics Physician in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.