Shanaaz Shameen Mohammed, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

51780 Issued in CT

Practice address

320 Western Blvd Ste 104
Glastonbury, CT 06033-1276

Phone

(860) 657-5940

NPI assigned

Sep 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, CT, TX4 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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanaaz.mohammed.npi1245426626.phpct@direct.optumcare.masshiway.net

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.

• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215923131
  Medicare reassignment NPD
• Mashantucket Pequot Tribal Council

  • Family Medicine Physician
  • Ledyard, CT
  • NPI 1508140922

  TX

  Medicare reassignment NPD
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Internal Medicine

  Medicare reassignment NPD
• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CT

  Medicare reassignment NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215518733
  NPD
• Lswhb LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Milford, OH
  • NPI 1407325939
  NPD
• Portage Physician Practices Inc

  • Rural Health Clinic/Center
  • Calumet, MI
  • NPI 1164106910
  NPD

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1245426626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 25272",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "33320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WESTERN BLVD STE 104",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331276",
            "telephone_number": "860-657-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "SHANAAZ",
        "middle_name": "SHAMEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "51780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Mira, BCBA
• Nancy Mitchell
• Mla Counseling Services LLC
• Mobile Hearing Solutions of Connecticut LLC
• Kathie H. Moffitt, PH.D
• Stephanie Mola
• Richard D Molk, MD
• Elizabeth Ann Monahan, MS ED LMFT
• Melissa A Monroe, MA, LPC
• Montera Health Connecticut LLC

• Internal Medicine Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.