Mohamed Mohamed

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

ME169214 Issued in FL

Practice address

1887 Kingsley Ave Ste 1900
Orange Park, FL 32073-4451

Phone

(904) 276-2549

Fax

(904) 276-9235

NPI assigned

Mar 23, 2017

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
• Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134
• HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mohamed.mohamed@hca5.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Trauma Services, LLC

  • Trauma Surgery Physician
  • Fort Walton Beach, FL
  • NPI 1477296952
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baker County Medical Services Inc

  • Rural Acute Care Hospital
  • Macclenny, FL
  • NPI 1104926401
  Care Compare affiliation
• Orange Park Medical Center, Inc.

  dba HCA Florida Orange Park Hospital

  • General Acute Care Hospital
  • Orange Park, FL
  • NPI 1689611501
  Care Compare affiliation
• Putnam Community Medical Center of North Florida, LLC

  dba HCA Florida Putnam Hospital

  • General Acute Care Hospital
  • Palatka, FL
  • NPI 1487045100
  Care Compare affiliation

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1275064982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE STE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734451",
            "telephone_number": "904-276-2549",
            "fax_number": "904-276-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE STE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734451",
            "telephone_number": "904-276-2549",
            "fax_number": "904-276-9235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-1280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME169214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreea Mocanu, OD
• Modern Periodontics, PA
• Modified Independence Evaluations Inc
• Houyar Moghaddas, M.D.
• Arshia Mohajerin, M.D.
• Mohammad Taj LLC
• Terri Lynn Molineaux, APRN
• Lewis Leonard Monroe, FNP-C, PMHNP-BC
• Lauren Kristine Montano, PA-C
• Montega Family Medicine PA (Montega Medical)

• Surgical Critical Care Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Surgical Critical Care Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.