NPIMap

Individual provider Active NPI

Muna Ahmed Elfaki Mohamad

  • Hospitalist Physician
  • Pueblo, CO
National Provider Identifier
1154099976
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DR0072638 Issued in CO
Practice address
400 W 16TH St
Pueblo, CO 81003
Phone
(719) 584-4921
Fax
(719) 595-7994
NPI assigned
Sep 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125078696 IL
Hospitalist Physician 208M00000X DR0072638 CO Primary

Addresses

Primary practice location

400 W 16TH St
Pueblo, CO 81003

Mailing address

2800 N Lake Shore Dr Apt 3111
Chicago, IL 60657-6275
Phone (773) 543-6014

Other practice location 1

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-6730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605001466 CO Practitioner - Hospitalist 9537601596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0072638COMDHospitalist Physician
125078696ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Pueblo Pathology Group, PC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1630886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1154099976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N LAKE SHORE DR APT 3111",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576275",
            "telephone_number": "773-543-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-584-4921",
            "fax_number": "719-595-7994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "773-665-6730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMAD",
        "first_name": "MUNA",
        "middle_name": "AHMED ELFAKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-06",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125078696",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR0072638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.