NPIMap

Individual provider Active NPI

Ehtaisham Uddin Mohammed, M.D

  • Family Medicine Physician
  • Arlington, MN
National Provider Identifier
1508077934
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49338 Issued in MN
Practice address
601 W Chandler St
Arlington, MN 55307-2127
Phone
(507) 964-2271
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49338 MN Primary

Addresses

Primary practice location

601 W Chandler St
Arlington, MN 55307-2127

Mailing address

1825 Red Oak RDG
Carver, MN 55315-4568
Phone (269) 330-0013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20070720000136 MN Practitioner - Family Practice 6709987787 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

111 Hundertmark Rd
Suite 220
Chaska, MN 55318-1197
Phone (952) 856-4001

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

  • Ridgeview Home Care Services Home health agency, Waconia, MN, CCN 247168
  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056
  • Ridgeview Sibley Medical Center Hospital, Arlington, MN, CCN 241311
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49338MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Current Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Mar 1, 2017 Accepting new patients
St. Francis Regional Medical Center CurrentSince May 1, 2020 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Mar 1, 2017 Accepting new patients
St Francis Regional Medical Center CurrentSince May 1, 2020 Accepting new patients
Sibley Medical Center CurrentSince Jan 1, 2014 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients

Locations

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001

111 Hundertmark Rd
Chaska, MN 55318
Phone (952) 361-2447

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

6150 Egan Dr
Savage, MN 55378
Phone (952) 228-2552

8170 Old Carriage Ct
Ste 100
Shakopee, MN 55379
Phone (952) 428-3600

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

500 S Maple St
Ofc
Waconia, MN 55387

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1508077934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 RED OAK RDG",
            "city": "CARVER",
            "state": "MN",
            "postal_code": "553154568",
            "telephone_number": "269-330-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W CHANDLER ST",
            "city": "ARLINGTON",
            "state": "MN",
            "postal_code": "553072127",
            "telephone_number": "507-964-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "EHTAISHAM",
        "middle_name": "UDDIN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "49338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MN

Sources for this page

Verify at the official NPI Registry.