Shannon Naresh Mohabir, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

75806 Issued in CT

Practice address

439 Mill Hill Ave
Bridgeport, CT 06610-2866

Phone

(203) 334-2100

NPI assigned

Apr 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Internal Medicine

Education

Nova Southeastern College of Osteo Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Cardiovascular Specialists PCGroup PAC ID 4880678846, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smohabir630417@direct.ynhh.org

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.

• Advanced Cardiovascular Specialists PC

  • Cardiovascular Disease Physician
  • Bridgeport, CT
  • NPI 1902957970
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1376162826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 MILL HILL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102866",
            "telephone_number": "203-334-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 MILL HILL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102866",
            "telephone_number": "203-334-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 68th St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330161801",
            "country_code": "US",
            "telephone_number": "305-364-2107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHABIR",
        "first_name": "SHANNON",
        "middle_name": "NARESH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "75806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Era Pediatric Practice
• Ingrid E Mody, PA-C
• Oak Gar Moe
• Andrea Teresa Moenkemoeller
• Balaphanidhar Mogga, MD
• Mohamed Mahmoud El Sayed Mohamed, MD
• Rowa Ali Dafaallah Mohamed, MD
• Rasheed Mohammed, TRANSPORTATION
• Kirithika Mohanathaas, M.D.
• Christopher Francis Mojcik, MD, PHD

• Internal Medicine Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.