Individual provider Active NPI

Mohammad Golam Saklayen, M.D.

  • Nephrology Physician
  • Dayton, OH
National Provider Identifier
1194738757
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35 046160 Issued in OH
Practice address
4100 W 3Rd St
Dayton, OH 45428-9000
Phone
(937) 268-6511
Fax
(937) 267-7689
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35 046160 OH Primary

Addresses

Primary practice location

4100 W 3Rd St
Dayton, OH 45428-9000

Mailing address

10351 Yellow Locust LN
Dayton, OH 45458-9470
Phone (937) 885-7742

Other identifiers 1

IdentifierTypeStateIssuer
2217765MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100913000239 OH Practitioner - NephrologyPractitioner - Internal Medicine 7810012051 Reassigns benefits to 2 organizations
Practice locations: Troy, OH

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35 046160OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clincare International Center LTD CurrentSince Apr 1, 2015 Accepting new patients
Clincare International Center LTD Nephrology CurrentSince Apr 1, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2416 Esquire Dr
Ste B
Beavercreek, OH 45431
Phone (937) 429-2422

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10693/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1194738757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 YELLOW LOCUST LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454589470",
            "telephone_number": "937-885-7742",
            "fax_number": "937-267-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-268-6511",
            "fax_number": "937-267-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKLAYEN",
        "first_name": "MOHAMMAD",
        "middle_name": "GOLAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35 046160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2217765",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.