Individual provider Active NPI

Mohammed A Haque, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1386661965
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N3715 Issued in TX
Practice address
855 Montgomery St
Fort Worth, TX 76107-2553
Phone
(817) 920-7400
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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 10569R LA
Internal Medicine Physician 207R00000X N3715 TX Primary

Addresses

Primary practice location

855 Montgomery St
Fort Worth, TX 76107-2553

Mailing address

PO Box 99335
Fort Worth, TX 76199-0335

Other identifiers 4

IdentifierTypeStateIssuer
1992054MedicaidLA
P01599379OtherTXRAILROAD MEDICARE
213393607MedicaidTX
8EC622OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100726000621 TX Practitioner - Internal Medicine 2264440213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

4701 Bryant Irvin Rd N
Fort Worth, TX 76107-7627
Phone (817) 702-7400

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10569RLAMDInternal Medicine Physician
N3715TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc Internal Medicine CurrentSince May 1, 2016 Accepting new patients
Westbank Physician Associates Internal Medicine PastSince Jun 23, 1994 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

4701 Bryant Irvin Rd N
Ft Worth, TX 76107
Phone (817) 702-7400

855 Montgomery St
Ft Worth, TX 76107
Phone (817) 735-2334

Organizations & group practices 2

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 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1386661965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-920-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "MOHAMMED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "10569R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N3715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992054",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01599379",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213393607",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EC622",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.