Individual provider Active NPI

Mohammad Mustafa Saidan, M.D

  • Internal Medicine Physician
  • Leesville, LA
National Provider Identifier
1336455377
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.204095 Issued in LA
Practice address
1020 Fertitta Blvd
Byrd Regional Hospital,
Leesville, LA 71446
Phone
(337) 239-5119
NPI assigned
Aug 27, 2010
Last updated
Aug 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.204095 LA Primary

Addresses

Primary practice location

1020 Fertitta Blvd
Byrd Regional Hospital,
Leesville, LA 71446

Mailing address

1020 Fertitta Blvd
Byrd Regional Hospital,
Leesville, LA 71446
Phone (337) 239-5119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112000947 LA Practitioner - Internal MedicinePractitioner - Emergency Medicine 6204025877 Reassigns benefits to 8 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Oakdale LLC Current Accepting new patients
Concord Medical Group PLLC CurrentSince Oct 7, 2014 Accepting new patients
Ambassador Physician Services LLC CurrentSince Jul 1, 2014 Accepting new patients
CLHG-Oakdale LLC CurrentSince Jun 27, 2019 Accepting new patients
Central Louisiana Physicians, LLC Internal Medicine CurrentSince Jan 8, 2024 Accepting new patients
Opelousas Physician Services LLC CurrentSince Jul 1, 2013 Accepting new patients
Coolidge Physician Services LLC CurrentSince Feb 21, 2014 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Oct 7, 2014 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

130 Hospital Dr
Oakdale, LA 71463
Phone (318) 215-3084

400 E 6th Ave
Oakdale, LA 71463
Phone (318) 335-3501

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Interoperability endpoints

  • Direct secure messaging: asmmsaidan@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vernon Home HealthLeesville, LA, CCN 197413 Home health agency 5% Or Greater Direct Ownership Interest (7%) Jan 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1336455377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 FERTITTA BLVD",
            "address_2": "BYRD REGIONAL HOSPITAL,",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "71446",
            "telephone_number": "337-239-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FERTITTA BLVD",
            "address_2": "BYRD REGIONAL HOSPITAL,",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "71446",
            "telephone_number": "337-239-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAIDAN",
        "first_name": "MOHAMMAD",
        "middle_name": "MUSTAFA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.204095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.