Individual provider Active NPI

Magid M Fahim, M.D.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1356548267
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.124288 Issued in IL
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(877) 866-7123
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2006015933 MO
Family Medicine Physician 207Q00000X 036.124288 IL Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

3635 Vista Avenue at Grand Blvd.
St. Louis, MO 63110-0250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000104 IL Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 8123294626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Wound Physicians of Il SCGroup PAC ID 9830377688, 20 clinicians

Practice addresses (Care Compare)

1115 N Wenthe Dr
Effingham, IL 62401-1612
Phone (877) 866-7123

1301 E Deyoung St
Marion, IL 62959-3846
Phone (877) 866-7123

1501 Sandbar Dr
Marion, IL 62959-5014
Phone (877) 866-7123

1900 N Park Ave
Herrin, IL 62948-2742
Phone (877) 866-7123

315 Brady Mill Rd
Anna, IL 62906-2306
Phone (877) 866-7123

606 E Il Hwy 15
Mount Vernon, IL 62864-5072
Phone (877) 866-7123

7370 W Talcott Ave
Chicago, IL 60631-3751
Phone (877) 866-7123

Hospital & facility affiliations

  • Breeze Hospice Hospice, Shiloh, IL, CCN 141659
  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue5867
Removal of skin lesions117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.124288ILMDFamily Medicine Physician
2006015933MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of Il, S.C. Family Medicine CurrentSince Jan 30, 2012 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

7370 W Talcott Ave
Chicago, IL 60631
Phone (312) 783-3348

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2474/brand/3/csg/81/fhir/r4

Organizations & group practices 1

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1356548267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVENUE AT GRAND BLVD.",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631100250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHIM",
        "first_name": "MAGID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2006015933",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.124288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.