Individual provider Active NPI

Parham Mora, M.D.

  • Surgery Physician
  • Prattville, AL
National Provider Identifier
1417915679
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20392 Issued in AL
Practice address
645 McQueen Smith Rd N
Suite 205
Prattville, AL 36066-7268
Phone
(334) 361-6126
Fax
(334) 361-6177
NPI assigned
May 3, 2006
Last updated
Aug 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 20392 AL Primary

Addresses

Primary practice location

645 McQueen Smith Rd N
Suite 205
Prattville, AL 36066-7268

Mailing address

645 McQueen Smith Rd N
Suite 205
Prattville, AL 36066-7268
Phone (334) 361-6126

Other identifiers 4

IdentifierTypeStateIssuer
51501010OtherALBLUE CROSS I.D.
020048725OtherALRAILROAD MEDICARE I.D.
051501010MedicaidAL
529909730MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20091027000581 AL Practitioner - General Surgery 7214074061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
George Washington University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Hospital and Clinic, IncGroup PAC ID 0547254153, 119 clinicians

Practice addresses (Care Compare)

124 S Memorial Dr
Prattville, AL 36067-3619
Phone (334) 264-9191

1722 Pine St
Montgomery, AL 36106-1160

554 McQueen Smith Rd N
Prattville, AL 36066-5558
Phone (334) 264-8741

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.18 of 100Reported as individual
Quality
43.95
Promoting interoperability
100
Improvement activities
40
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy109
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux50
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20392ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Jackson Hospital and Clinic Inc. Surgery CurrentSince Jun 21, 2022 Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Jun 21, 2022 Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients

Locations

1722 Pine St
Ste 203
Montgomery, AL 36106
Phone (334) 271-1263

1722 Pine St
Ste 502
Montgomery, AL 36106
Phone (334) 293-8123

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1801 Pine St
Ste 103
Montgomery, AL 36106
Phone (334) 293-8888

Interoperability endpoints

  • Direct secure messaging: parham.mora.1@9186.direct.athenahealth.com
  • Direct secure messaging: parham.mora@direct.baptistfirst.org

Organizations & group practices 4

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.

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1417915679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 MCQUEEN SMITH RD N",
            "address_2": "SUITE 205",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667268",
            "telephone_number": "334-361-6126",
            "fax_number": "334-361-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 MCQUEEN SMITH RD N",
            "address_2": "SUITE 205",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667268",
            "telephone_number": "334-361-6126",
            "fax_number": "334-361-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "PARHAM",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "20392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS I.D.",
            "identifier": "51501010",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE I.D.",
            "identifier": "020048725",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051501010",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529909730",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

Verify at the official NPI Registry.