Mohammad Salah Agha, MD
Individual provider Active NPI Hospitalist Physician · Dayton, OH
NPI 1467607291 · NPPES record last updated Oct 15, 2021
Key facts
- NPI
- 1467607291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- 35.135363 (OH)
- Practice address
- 1 Childrens PLZ
Dayton, OH 45404-1815 - Phone
- (937) 641-3000
- NPI assigned
- Nov 20, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190307001320 | OH | Practitioner - Hospitalist | 3678747417 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.135363 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dayton Children'S Specialty Physicians, Inc. | Pediatrics | Current |
Accepting new patients |
| Adena Medical Group LLC | Pediatrics | Current |
Accepting new patients |
| Dayton Children'S Specialty Physicians, Inc. | Pediatrics | Current |
Accepting new patients |
Locations
272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275
1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600
967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330
12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.135363 | OH | |
| Hospitalist Physician | 208M00000X | 35.135363 | OH | Yes |
Addresses
Primary practice location
1 Childrens PLZ
Dayton, OH 45404-1815
Mailing address
1 Childrens PLZ
Dayton, OH 45404-1815
Phone (937) 641-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0269583 | Medicaid | OH |
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.