Active NPI
Mohammad Idrees, M.D.
- Internal Medicine Physician
- Palm Bay, FL
National Provider Identifier
1285649905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME22385
- Practice address
- 1454 Bellaire LN
Palm Bay, FL 32905 - Phone
- (321) 723-2121
- Fax
- (321) 541-8110
- NPI assigned
- Jul 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME22385 | FL | Primary |
Addresses
Primary practice location
1454 Bellaire LN
Palm Bay, FL 32905
Mailing address
1454 Bellaire LN
Palm Bay, FL 32905
Phone (321) 723-2121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0544841 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1285649905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1454 BELLAIRE LN",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32905",
"telephone_number": "321-723-2121",
"fax_number": "321-541-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1454 BELLAIRE LN",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32905",
"telephone_number": "321-723-2121",
"fax_number": "321-541-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDREES",
"first_name": "MOHAMMAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-30",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME22385",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0544841",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.