Individual provider Active NPI

Mohamad Adam, M.D.

  • Internal Medicine Physician
  • Sylvania, OH
National Provider Identifier
1114231297
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
120693 Issued in OH
Practice address
5200 Harroun Rd
Sylvania, OH 43560-2168
Phone
(312) 504-3267
NPI assigned
Aug 2, 2010
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 120693 OH Primary
Hospitalist Physician 208M00000X 036133490 IL

Addresses

Primary practice location

5200 Harroun Rd
Sylvania, OH 43560-2168

Mailing address

1870 Burton LN
Park Ridge, IL 60068-1570
Phone (312) 504-3267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140626000395 IL Practitioner - Internal Medicine 5496980500
I20150113000348 OH Practitioner - HospitalistPractitioner - Internal Medicine 5496980500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 479-5690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
120693OHMDInternal Medicine Physician
036133490ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Apogee Medical Group Ohio Inc Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Toledo Clinic Incorporated CurrentSince Apr 1, 2016 Accepting new patients
The Toledo Hospital Past Accepting new patients

Locations

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

Organizations & group practices 4

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 3

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": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1114231297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 BURTON LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681570",
            "telephone_number": "312-504-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARROUN RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602168",
            "telephone_number": "312-504-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAM",
        "first_name": "MOHAMAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-02",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "120693",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036133490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.