NPIMap

Individual provider Active NPI

Khaldoun Mohamad Mozahem, MD

  • Neurology Physician
  • Bridgeport, WV
National Provider Identifier
1346730504
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
26493 Issued in WV
Practice address
527 Medical Park Drive
Suite 204
Bridgeport, WV 26330
Phone
(304) 933-3800
Fax
(304) 933-3815
NPI assigned
May 14, 2018
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 26493 WV
Neurology Physician 2084N0400X 26493 WV Primary

Addresses

Primary practice location

527 Medical Park Drive
Suite 204
Bridgeport, WV 26330

Mailing address

527 Medical Park Drive
Suite 204
Bridgeport, WV 26330
Phone (304) 933-3800

Other practice location 1

2199 Cheat Rd
Morgantown, WV 26508-4451
Phone (304) 594-3258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20180718002971 WV Practitioner - NeurologyPractitioner - Sleep Medicine 3971850132 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Sleep Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preston Memorial Hospital CorporationGroup PAC ID 5294645107, shared by 3 NPIs, 46 clinicians
Stonewall Jackson Memorial Hospital CompanyGroup PAC ID 4284530551, 64 clinicians

Practice addresses (Care Compare)

12302 Veterans Memorial Hwy
Suite 4
Reedsville, WV 26547-6501
Phone (304) 980-2006

2199 Cheat Rd
Morgantown, WV 26508-4451
Phone (304) 594-3258

230 Hospital PLZ
Weston, WV 26452-8558
Phone (304) 269-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Memorial Hospital Corporation CurrentSince Dec 8, 2018 Accepting new patients
Associated Specialists, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Monongalia County General Hospital Company CurrentSince Oct 1, 2022 Accepting new patients
Stonewall Jackson Memorial Hospital Company CurrentSince Aug 23, 2022 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Dec 8, 2018 Accepting new patients
Stonewall Jackson Memorial Hospital Company CurrentSince Aug 23, 2022 Accepting new patients
Family Medical Clinic of Jane Lew Past Accepting new patients
Braxton County Memorial Hospital Past Accepting new patients

Locations

527 Medical Park Dr
Ste 204
Bridgeport, WV 26330
Phone (304) 623-5711

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

1000 Mon Health Medical Park Dr
Ste 1103
Morgantown, WV 26505
Phone (304) 285-2835

1188 Pineview Dr
#100
Morgantown, WV 26505
Phone (304) 599-7934

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

2199 Cheat Rd
Morgantown, WV 26508
Phone (304) 594-3258

12302 Veterans Memorial Hwy
Ste 4
Reedsville, WV 26547
Phone (304) 980-2006

12302 Veterans Memorial Hwy
Ste 5
Reedsville, WV 26547
Phone (304) 864-2290

230 Hospital Plz
Weston, WV 26452
Phone (304) 269-8000

29 Hospital Plz
Ste B
Weston, WV 26452
Phone (304) 269-0030

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24
  • Direct secure messaging: khaldoun.mozahem@asidrs.directbygreenway.com

Organizations & group practices 8

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.

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1346730504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2199 Cheat Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265084451",
            "country_code": "US",
            "telephone_number": "304-594-3258",
            "fax_number": "304-594-3498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOZAHEM",
        "first_name": "KHALDOUN",
        "middle_name": "MOHAMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "WV",
            "license": "26493",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WV",
            "license": "26493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.