Individual provider Active NPI

Mohammad Qasim, MD

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1366532830
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-.3860 Issued in AR
Practice address
800 Marshall St # 653
Little Rock, AR 72202-3510
Phone
(501) 364-1100
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-.3860 AR Primary
Pain Medicine Physician 208VP0000X E-.3860 AR

Addresses

Primary practice location

800 Marshall St # 653
Little Rock, AR 72202-3510

Mailing address

800 Marshall St # 653
Little Rock, AR 72202-3510
Phone (501) 364-1100

Other identifiers 1

IdentifierTypeStateIssuer
154127001MedicaidAR

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
I20080724000276 IL Practitioner - Anesthesiology 3870584568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Anesthesiologists LTDGroup PAC ID 0547165524, 26 clinicians

Practice addresses (Care Compare)

17800 S Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 799-8000

2320 E 93Rd St
Chicago, IL 60617-3909
Phone (773) 967-2000

Hospital & facility affiliations

  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-.3860ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesiologists, LTD. Anesthesiology CurrentSince Mar 27, 2011 Accepting new patients

Locations

3407 Momentum Pl
Chicago, IL 60689

185 Penny Ave
East Dundee, IL 60118
Phone (847) 836-7015

17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200

6311 W 95th St
Oak Lawn, IL 60453
Phone (708) 423-2258

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

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 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1366532830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QASIM",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-.3860",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AR",
            "license": "E-.3860",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154127001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.