NPIMap

Individual provider Active NPI

Nabeel Muhammad Imam, M.D

  • Nephrology Physician
  • Oregon, OH
National Provider Identifier
1275859795
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
123949 Issued in OH
Practice address
2702 Navarre Ave
201
Oregon, OH 43616-3223
Phone
(419) 698-8560
Fax
(419) 698-8570
NPI assigned
Apr 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X 123949 OH Primary

Addresses

Primary practice location

2702 Navarre Ave
201
Oregon, OH 43616-3223

Mailing address

2702 Navarre Ave
201
Oregon, OH 43616-3223
Phone (419) 698-8560

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherOHAPPLIED FOR MEDICARE NUMBER IN OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140728000204 OH Practitioner - NephrologyPractitioner - Internal Medicine 7113179060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Services of Toledo, IncGroup PAC ID 2860417789, 3 clinicians

Practice addresses (Care Compare)

2702 Navarre Ave
Suite 201
Oregon, OH 43616-3224
Phone (419) 698-8560

Hospital & facility affiliations

  • DaVita Maumee Bay Dialysis Dialysis facility, Oregon, OH, CCN 362547
  • DaVita Southland at Home Dialysis facility, Toledo, OH, CCN 362509
  • DaVita Starr Dialysis Dialysis facility, Toledo, OH, CCN 362885
  • DaVita Point Place Dialysis Dialysis facility, Toledo, OH, CCN 362712
  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123949OHMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: nimam132277@direct.bsmhealth.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.

Hospital & facility affiliations 8

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": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1275859795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NAVARRE AVE",
            "address_2": "201",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163223",
            "telephone_number": "419-698-8560",
            "fax_number": "419-698-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 NAVARRE AVE",
            "address_2": "201",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163223",
            "telephone_number": "419-698-8560",
            "fax_number": "419-698-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "NABEEL",
        "middle_name": "MUHAMMAD",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "123949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLIED FOR MEDICARE NUMBER IN OHIO",
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.