Mohamad A Abdelazeez Khaled, MD
Individual provider Active NPI Neurological Surgery Physician · Springfield, MA
NPI 1285825604 · NPPES record last updated Apr 23, 2019
Key facts
- NPI
- 1285825604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- 54621 (CT)
- Practice address
- 2 Medical Center Drive
Suite 503
Springfield, MA 01199-1619 - Phone
- (413) 794-5600
- Fax
- (413) 794-5242
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Neurosurgery
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hartford Healthcare Medical Group Specialists PLLC
Practice addresses (Care Compare)
85 Seymour St
Suite 1003
Hartford, CT 06106-5529
Phone (860) 696-2290
Hospital & facility affiliations
- Hartford Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 90 |
| Laminectomy or laminotomy (partial removal of spine bones) | 24 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151022001504 | MA | Practitioner - Neurosurgery | 3577793744 | Reassigns benefits to 1 organization |
| I20190122001300 | CT | Practitioner - Neurosurgery | 3577793744 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54621 | CT | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group, Inc | Current |
Accepting new patients | |
| Hartford Hospital | Neurological Surgery | Current |
Accepting new patients |
| Hartford Healthcare Medical Group Specialists LLC | Current |
Accepting new patients | |
| Baystate Medical Practices, Inc | Neurological Surgery | Current |
Accepting new patients |
| Hartford Healthcare Medical Group Specialists, PLLC | Neurological Surgery | Current |
Accepting new patients |
| Hartford Hospital | Current |
Accepting new patients |
Locations
100 Hazard Ave
Enfield, CT 06082
Phone (860) 696-2380
85 Seymour St
Ste 1019
Hartford, CT 06106
Phone (860) 246-4029
85 Seymour St
Ste 1003
Hartford, CT 06106
Phone (860) 246-4260
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
2 Medical Center Dr
Ste 503
Springfield, MA 01107
Phone (413) 794-4440
280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385
759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233
Interoperability endpoints
- mohamad.khaled@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 262884 | MA | |
| Neurological Surgery Physician | 207T00000X | 54621 | CT | Yes |
Addresses
Primary practice location
2 Medical Center Drive
Suite 503
Springfield, MA 01199-1619
Mailing address
1290 Silas Deane Hwy
HHC Cvo
Wethersfield, CT 06109-4337
Phone (860) 972-9033
Other practice location 1
85 Seymour St Ste 1003
Hartford, CT 06106
Phone (860) 696-2290
Other names
- Mohamad Abdelazeeez Khaled
Other providers in Springfield, MA
- Jaime Lynn Abbiati
- Brianna Michelle Abbott
- Nelson Abdala
- Sharon M Abdalla
- Mohamed Abdelazeem
- Albatool Abdelghaffar
- Mahmoud Samy Mohamed Abdelghany
- Fatima Abdelmagid
- Nur Abdi
- Zainab S Abdi
All providers in Springfield, MA · Neurological Surgery Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.