Individual provider Active NPI

Mohamed Kamal Katirji, MD

  • Internal Medicine Physician
  • Akron, OH
National Provider Identifier
1417928540
Registry record updated Mar 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3544744 Issued in OH
Practice address
215 E Waterloo Rd
Ste 10
Akron, OH 44319-1236
Phone
(330) 773-8221
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3544744 OH Primary

Addresses

Primary practice location

215 E Waterloo Rd
Ste 10
Akron, OH 44319-1236

Mailing address

215 E Waterloo Rd
Ste 10
Akron, OH 44319-1236
Phone (330) 773-8221

Other identifiers 1

IdentifierTypeStateIssuer
0427765MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3544744OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC Internal Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332547200000",
    "number": "1417928540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E WATERLOO RD",
            "address_2": "STE 10",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443191236",
            "telephone_number": "330-773-8221",
            "fax_number": "330-773-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E WATERLOO RD",
            "address_2": "STE 10",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443191236",
            "telephone_number": "330-773-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATIRJI",
        "first_name": "MOHAMED",
        "middle_name": "KAMAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "3544744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427765",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2012; 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.