NPIMap

Individual provider Active NPI

Fazleomar Mahmood, MD

  • Rheumatology Physician
  • Chelsea, MI
National Provider Identifier
1275585200
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301080247 Issued in MI
Practice address
14650 E Old US Highway 12
Suite 301
Chelsea, MI 48118-1801
Phone
(734) 593-5990
Fax
(734) 593-5995
NPI assigned
May 17, 2006
Last updated
Jul 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X FM080247 MI
Rheumatology Physician 207RR0500X 4301080247 MI Primary

Addresses

Primary practice location

14650 E Old US Highway 12
Suite 301
Chelsea, MI 48118-1801

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060807000402 MI Practitioner - RheumatologyPractitioner - Internal Medicine 1850394115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

14650 E Old US Hwy 12
Suite 301
Chelsea, MI 48118-1805
Phone (734) 593-5990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FM080247MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation CurrentSince Jul 20, 2015 Accepting new patients
Iha Health Service Corporation CurrentSince Jul 20, 2015 Accepting new patients
Pulsar Medical Group PC Internal Medicine Past Accepting new patients
Macomb Internists PC Internal Medicine Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

14650 E Old US Highway 12
Ste 101
Chelsea, MI 48118
Phone (734) 475-3979

14650 E Old US Highway 12
Ste 301
Chelsea, MI 48118
Phone (734) 426-1925

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1275585200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 E OLD US HIGHWAY 12",
            "address_2": "SUITE 301",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181801",
            "telephone_number": "734-593-5990",
            "fax_number": "734-593-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "FAZLEOMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "FM080247",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301080247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.