Ali M Mohamed, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

046623 Issued in GA

Practice address

1459 Montreal Rd
Ste 312
Tucker, GA 30084-6900

Phone

(770) 270-4060

Fax

(770) 270-4061

NPI assigned

Mar 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Practice roles

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.

• Dekalb Internal Medicine Associates, PC

  • Primary Care Clinic/Center
  • Tucker, GA
  • NPI 1255615852
  NPD (past) Authorized official

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154448967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "address_2": "STE 312",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "770-270-4060",
            "fax_number": "770-270-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "address_2": "STE 312",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "770-270-4060",
            "fax_number": "770-270-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "ALI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00815075B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007493308",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52667599",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Miner, PT
• Alice D Mintz, CNS
• Takera Mitchell, RN
• Warren Mitchell, LCSW
• MLB Transportation Inc
• Brianna Monique Molina
• Sanders Mompremier, M.D.
• Mona Venus Skin Care LLC
• Mark Monterola
• Montreal Internal Medicine Associates, PC

• Internal Medicine Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.