Individual provider Active NPI

Mohammed Sayeedur Rais, MD

  • Interventional Cardiology Physician
  • Thibodaux, LA
National Provider Identifier
1093712028
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
14182R Issued in LA
Practice address
1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone
(985) 446-2021
Fax
(985) 447-1546
NPI assigned
Jul 6, 2005
Last updated
Feb 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 14182R LA
Interventional Cardiology Physician 207RI0011X 14182R LA Primary

Addresses

Primary practice location

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886

Mailing address

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone (985) 446-2021

Other identifiers 1

IdentifierTypeStateIssuer
1185965MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20100318000045 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618002460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone (985) 446-2021

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal71
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14182RLAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation PastSince Feb 16, 2020 Accepting new patients
Laborde Therapy Center LLC PastSince Jun 7, 2010 Accepting new patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients

Locations

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Interoperability endpoints

  • Direct secure messaging: mrais158494@direct.ochsner.org

Organizations & group practices 5

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 4

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": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1093712028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MARTIN LUTHER KING DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014886",
            "telephone_number": "985-446-2021",
            "fax_number": "985-447-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MARTIN LUTHER KING DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014886",
            "telephone_number": "985-446-2021",
            "fax_number": "985-447-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIS",
        "first_name": "MOHAMMED",
        "middle_name": "SAYEEDUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "14182R",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "14182R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1185965",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.