Ni Mo, D.O.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

20A16690 Issued in CA

Practice address

4501 Sand Creek Rd
Antioch, CA 94531-8687

Phone

(925) 813-6500

NPI assigned

Mar 19, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal MedicineAlso: Hospitalist

Education

Midwestern University, Chicago College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital - Antioch Hospital, Antioch, CA, CCN 050760

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Antioch

  • General Acute Care Hospital
  • Antioch, CA
  • NPI 1851417547
  Care Compare affiliation

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

{
    "created_epoch": "1489881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1285175539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 SAND CREEK RD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 SAND CREEK RD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318687",
            "telephone_number": "925-813-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4077 Fifth Ave",
            "address_2": "# Mer35",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032105",
            "country_code": "US",
            "telephone_number": "510-565-4087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MO",
        "first_name": "NI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-19",
        "last_updated": "2021-12-17",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A16690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Sand Creek Rd",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945318687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Miramontes
• Crystal Miran, P.A.-C
• Elika Mirzaagha, DDS
• Tripurari Mishra, M.D.
• Anita Mittal, MD
• Kourosh Moazemi, MD
• Benjamin Ray Mock
• Darcy Modabber, DPT
• Aisha Mohammed Swan, PHD, PSYD
• Elizabeth T Mok, PHARM. D.

• Hospitalist Physician in Antioch, CA
• Providers in Antioch, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.