Active NPI
Mohamad Minhem, M.D.
- Internal Medicine Physician
- Decatur, IL
National Provider Identifier
1154816445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036.161009
- Practice address
- 1800 E Lake Shore Dr
Decatur, IL 62521-3810 - Phone
- (217) 464-2966
- NPI assigned
- Jun 28, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036.161009 | IL | Primary |
Addresses
Primary practice location
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Mailing address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 464-2966
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mminhem363720@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.161009 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients |
Interoperability endpoints
- mminhem363720@ewd.direct.hshs.org
- mminhem130622@direct.luhs.org
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1154816445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 E LAKE SHORE DR",
"city": "DECATUR",
"state": "IL",
"postal_code": "625213810",
"telephone_number": "217-464-2966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 E LAKE SHORE DR",
"city": "DECATUR",
"state": "IL",
"postal_code": "625213810",
"telephone_number": "217-464-2966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINHEM",
"first_name": "MOHAMAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-28",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.161009",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mminhem363720@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "1800 E Lake Shore Dr",
"city": "Decatur",
"state": "IL",
"country_code": "US",
"postal_code": "625213810",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.