Jahangir A Momin, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

46733-020 Issued in WI

Practice address

3102 E Parkside Blvd
#7
Appleton, WI 54915-5607

Phone

(262) 538-1406

Fax

(262) 538-1406

NPI assigned

Jul 12, 2006

Last updated

Nov 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289692800000",
    "number": "1376578518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E PARKSIDE BLVD",
            "address_2": "#7",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549155607",
            "telephone_number": "262-538-1406",
            "fax_number": "262-538-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E PARKSIDE BLVD",
            "address_2": "#7",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549155607",
            "telephone_number": "262-538-1406",
            "fax_number": "262-538-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "JAHANGIR",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "46733-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34503700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Boyadjian Moks, MD
• Lou Ann Mokwa, APNP
• Timothy S Mologne, M.D.
• Marissa Moloney, DC
• Moments Hospice of Appleton LLC
• Monroe Biotechnology, Inc.
• Cheryl L Montag, APNP
• Brianna M Montano, PSYD
• Montera Health Wisconsin LLC
• Tatiana Monterrosaaguilar

• Nephrology Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Nephrology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2010; 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.