Masood Ahmad, M.D.
Individual provider Active NPI Psychiatry Physician · Jackson, MI
NPI 1366481905 · NPPES record last updated Aug 13, 2020
Key facts
- NPI
- 1366481905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 28864 (OK)
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 205-4730
- Fax
- (517) 205-4701
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Recovery Technology LLC
W. a. Foote Memorial Hospital, Inc.
Practice addresses (Care Compare)
1200 N W Ave
Suite 400
Jackson, MI 49202-2180
Phone (517) 780-3381
205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800
Hospital & facility affiliations
- Henry Ford Allegiance Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091208000340 | MI | Practitioner - Psychiatry | 4981600160 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301073723 | MI | MD | Psychiatry Physician |
| 0000035692 | TN | MD | General Practice Physician |
| 35692 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Pathology | Current | Accepting new patients | |
| Tuscola County Community Mental Health Services Board | Current |
Accepting new patients | |
| Bay-Arenac Behavioral Health | Current |
Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Psychiatry | Current |
Accepting new patients |
| W.a. Foote Memorial Hospital, Inc | Current |
Accepting new patients | |
| Omh Home Health | Past | Accepting new patients |
Locations
201 Mulholland St
Bay City, MI 48708
Phone (989) 895-2222
323 N State St
Caro, MI 48723
Phone (989) 673-6191
1332 Prospect Ave
Caro, MI 48723
Phone (989) 673-6191
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103
Interoperability endpoints
- mahmad519614@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301073723 | MI | |
| Psychiatry Physician | 2084P0800X | 35692 | TN | |
| General Practice Physician | 208D00000X | 0000035692 | TN | |
| Psychiatry Physician | 2084P0800X | 28864 | OK | Yes |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
6565 S Yale Ave
Suite 209
Tulsa, OK 74136-8327
Phone (918) 392-5400
Other practice location 1
6565 S Yale Ave
Suite 209
Tulsa, OK 74136-8327
Phone (918) 392-5400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3816082 | Medicaid | TN | |
| 200435250A | Medicaid | OK | |
| 1366481905 | Medicaid | MI |
Other providers in Jackson, MI
- Andrea Melissa Aguilar Corrales
- Ahern Family Chiropractic LLC
- Curtis Anthony Ahern
- Alexis Ahlbaum
- Joshua Paul Ahlstrom
- Mobeen Ahmad
- Sameer Ahmed
- Amanda Ahrens
- Samuel Olasoji Ajagbonna
- Matthew Ajayi
All providers in Jackson, MI · Psychiatry Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.