NPIMap

Individual provider Active NPI

Mohammed A Qadeer, MD

  • Gastroenterology Physician
  • Kenosha, WI
National Provider Identifier
1477750271
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
56543 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142
Phone
(262) 948-7000
NPI assigned
Jun 27, 2007
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2010-00189 NC
Gastroenterology Physician 207RG0100X 56543 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 948-7000

Other identifiers 2

IdentifierTypeStateIssuer
5914622MedicaidNC
1477750271MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mqadeer217019@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120525000242 WI Practitioner - Gastroenterology 1951205731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Upper gastrointestinal (GI) endoscopy for acid reflux224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-00189NCMDGastroenterology Physician
56543WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 29, 2018 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 29, 2018 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Apr 2, 2012 Accepting new patients
Wake Forest University Health Sciences Gastroenterology Past Accepting new patients
Gastroenterology Specialists SC Gastroenterology PastSince Apr 2, 2012 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3811 Spring St
Ste 202
Mount Pleasant, WI 53405
Phone (262) 687-8202

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: mqadeer217019@direct.myadvocateaurora.org

Organizations & group practices 7

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 3

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1477750271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-948-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-948-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QADEER",
        "first_name": "MOHAMMED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2010-00189",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "56543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5914622",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477750271",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mqadeer217019@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.