NPIMap

Organization Active NPI

Mohammad Ali Faisal Mdpa

  • Specialist
  • Lake City, FL
National Provider Identifier
1275944126
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MOHAMMAD ALI FAISAL MDPA
Practice address
1283 SW State Rd 47
Ste 104
Lake City, FL 32025
Phone
(386) 758-5985
NPI assigned
May 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Authorized official

Name
Mohammad Faisal MD
Title
President
Phone
(386) 758-5985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1283 SW State Rd 47
Ste 104
Lake City, FL 32025

Mailing address

PO Box 3009
Lake City, FL 32056

Other identifiers 1

IdentifierTypeStateIssuer
051283400MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Mohammad Ali Faisal MD P2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1283 SW State Road 47
Ste 104
Lake City, FL 32025
Phone (386) 758-5985

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1275944126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3009",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 SW STATE RD 47",
            "address_2": "STE 104",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-758-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD ALI FAISAL MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "FAISAL MD",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-758-5985"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051283400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.