Internal Medicine Associates of Mid-Ohio Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35073495 Issued in OH

Legal business name

INTERNAL MEDICINE ASSOCIATES OF MID-OHIO INC

Practice address

465 North Home Rd
Mansfield, OH 44906-2323

Phone

(419) 747-1601

Fax

(419) 747-1610

NPI assigned

Jul 25, 2006

Last updated

Apr 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mustafa S Garbadawala, MDNPI 1548294127

Title

Owner

Phone

(419) 747-1601

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mustafa S Garbadawala, M.D.

  • Internal Medicine Physician
  • Mansfield, OH
  • NPI 1548294127
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1417970922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 NORTH HOME RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062323",
            "telephone_number": "419-747-1601",
            "fax_number": "419-747-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 NORTH HOME RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062323",
            "telephone_number": "419-747-1601",
            "fax_number": "419-747-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF MID-OHIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "GARBADAWALA",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-747-1601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35073495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2131231",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.