Individual provider Active NPI

Morsal N. Mohammadi, APN

  • Nurse Practitioner
  • Summit, NJ
National Provider Identifier
1407512205
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1407512205 Issued in NJ
Practice address
33 Overlook Rd Ste 201
Summit, NJ 07901-3562
Phone
(908) 522-5045
Fax
(908) 522-5041
NPI assigned
Nov 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1407512205 NJ Primary

Addresses

Primary practice location

33 Overlook Rd Ste 201
Summit, NJ 07901-3562

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (866) 362-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220331003134 NJ Practitioner - Nurse Practitioner 0749676633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 441-1161

Hospital & facility affiliations

  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1407512205NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Feb 28, 2022 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

385 Morris Ave
Ste 2
Springfield, NJ 07081

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

33 Overlook Rd
Ste 201
Summit, NJ 07901
Phone (908) 522-4555

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 4

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": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1407512205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "866-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD STE 201",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013562",
            "telephone_number": "908-522-5045",
            "fax_number": "908-522-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMADI",
        "first_name": "MORSAL",
        "middle_name": "N.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "1407512205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.