NPIMap

Individual provider Active NPI

Mohammad H Motekallem, MD

  • Cardiovascular Disease Physician
  • Dayton, OH
National Provider Identifier
1366444556
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35-10-0203 Issued in OH
Practice address
1530 Needmore Rd
Ste 300
Dayton, OH 45414-3969
Phone
(937) 277-4274
Fax
(937) 277-8476
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.100203 OH
Cardiovascular Disease Physician 207RC0000X 35-10-0203 OH Primary

Addresses

Primary practice location

1530 Needmore Rd
Ste 300
Dayton, OH 45414-3969

Mailing address

1530 Needmore Rd
Ste 300
Dayton, OH 45414-3969
Phone (937) 277-4274

Other identifiers 1

IdentifierTypeStateIssuer
0866282MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Readers Group, Inc Past Accepting new patients
The Dayton Heart Center, Inc. Cardiovascular Disease Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Non-Invasive Interpretations Cardiovascular Disease Past Accepting new patients

Organizations & group practices 4

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1366444556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD",
            "address_2": "STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143969",
            "telephone_number": "937-277-4274",
            "fax_number": "937-277-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD",
            "address_2": "STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143969",
            "telephone_number": "937-277-4274",
            "fax_number": "937-277-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTEKALLEM",
        "first_name": "MOHAMMAD",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.100203",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-10-0203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0866282",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.