NPIMap

Individual provider Active NPI

Shaji A Mohammed

  • Internal Medicine Physician
  • Mt. Vernon, IL
National Provider Identifier
1316504939
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036161378 Issued in IL
Practice address
1 Good Samaritan Way
Mt. Vernon, IL 62864-1010
Phone
(618) 899-1006
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036161378 IL
Internal Medicine Physician 207R00000X 036161378 IL Primary

Addresses

Primary practice location

1 Good Samaritan Way
Mt. Vernon, IL 62864-1010

Mailing address

1005 Broadway
Quincy, IL 62301-2834
Phone (217) 223-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829001278 IL Practitioner - Internal Medicine 2163750712 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (557) 203-1601

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jul 20, 2022 Accepting new patients
Good Samaritan Regional Health Center Current Accepting new patients
Decatur Memorial Hospital CurrentSince Aug 14, 2025 Accepting new patients
Good Samaritan Regional Health Center CurrentSince Jul 11, 2025 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jul 20, 2022 Accepting new patients
Taylorville Memorial Hospital CurrentSince Aug 14, 2025 Accepting new patients
Taylorville Memorial Hospital CurrentSince Aug 14, 2025 Accepting new patients
Decatur Memorial Hospital Internal Medicine CurrentSince Aug 14, 2025 Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

5 Good Samaritan Way
Mount Vernon, IL 62864
Phone (557) 203-1601

201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555

Interoperability endpoints

  • Direct secure messaging: smohammed131364@direct.mhemail.org
  • Direct secure messaging: smohammed428381@direct-ehr-ssmhc.com

Organizations & group practices 12

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1316504939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOOD SAMARITAN WAY",
            "city": "MT. VERNON",
            "state": "IL",
            "postal_code": "628641010",
            "telephone_number": "618-899-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "SHAJI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036161378",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036161378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt. Vernon, IL

Sources for this page

Verify at the official NPI Registry.