Individual provider Active NPI

Mohamed Diab, M.D.

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1336765718
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1016657 Issued in MA
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4122
Phone
(585) 723-7746
Fax
(585) 723-7834
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32756-01 NY
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 1016657 MA Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4122

Mailing address

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240319001445 NY Practitioner - Hospitalist 9032556659 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1016657MAMDInternal Medicine Physician
32756-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Feb 6, 2024 Accepting new patients
Rochester General Hospital Internal Medicine CurrentSince Feb 6, 2024 Accepting new patients
Rochester General Hospital Internal Medicine Current Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital CurrentSince Feb 6, 2024 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1336765718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7746",
            "fax_number": "585-723-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7746",
            "fax_number": "585-723-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAB",
        "first_name": "MOHAMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "32756-01",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1016657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.