Individual provider Active NPI

Mohamed Adnan Alarayedh, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1477120962
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
36371 Issued in NE
Practice address
121 Dekalb Avenue
Brooklyn, NY 11201
Phone
(718) 250-6776
NPI assigned
Jun 4, 2021
Reactivated
Jun 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 36371 NE Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

121 Dekalb Avenue
Brooklyn, NY 11201

Mailing address

985524 Nebraska Medical Ctr
Omaha, NE 68198-5524
Phone (402) 559-6329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20240928000262 NE Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9739610932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36371NEMDNeonatal-Perinatal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: malarayedh18476@prd.direct.tbh.org

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1477120962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985524 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985524",
            "telephone_number": "402-559-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-250-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALARAYEDH",
        "first_name": "MOHAMED",
        "middle_name": "ADNAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "deactivation_date": "2023-03-24",
        "reactivation_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NE",
            "license": "36371",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.