Mohammed Azam, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101021280 Issued in MI

Practice address

3204 Tearose Dr
Richardson, TX 75082-3760

Phone

(630) 930-0776

NPI assigned

Jun 17, 2014

Sex

Male

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 IL

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 1

Specialty

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of Hope Medical Group of Illinois PLLCGroup PAC ID 3274446596, 129 clinicians

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Harvard Hospital Hospital, Harvard, IL, CCN 141335
• Midwestern Region Med Center, Inc Hospital, Zion, IL, CCN 140100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mazamdo237082@uchospital.direct-ci.com

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.

• City of Hope Medical Group of Illinois PLLC

  • Specialist
  • Zion, IL
  • NPI 1548258072
  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL

  Medicare reassignment Care Compare group NPD
• Mercy Harvard Hospital Inc

  • Critical Access Hospital
  • Harvard, IL
  • NPI 1427001445
  Medicare reassignment NPD
• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Mercy Harvard Hospital Inc

  • Skilled Nursing Facility
  • Harvard, IL
  • NPI 1124195557
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD

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

• Mercy Harvard Hospital Inc

  • Critical Access Hospital
  • Harvard, IL
  • NPI 1427001445
  Care Compare affiliation
• Midwestern Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Zion, IL
  • NPI 1811984388
  Care Compare affiliation

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1275947392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 TEAROSE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823760",
            "telephone_number": "630-930-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 TEAROSE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823760",
            "telephone_number": "630-930-0776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32780 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "farmington hill",
            "state": "MI",
            "postal_code": "48336",
            "country_code": "US",
            "telephone_number": "248-473-8247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZAM",
        "first_name": "MOHAMMED",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101021280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Axel Hospice Care,LLC
• Axis Neuromonitoring
• Axis Neuromonitoring Sa, LLC
• Ay Chiropractic,PLLC
• Jessica Ayala
• Azhala Medicare Transportation LLC
• Azhala Medicare Transportation LLC
• Syed Husain Aziz, MD
• Afshin Azmoodeh, D.D.S.
• Laila Azouggagh, PA-C

• Emergency Medicine Physician in Richardson, TX
• Providers in Richardson, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.