Individual provider Active NPI

Mohammad Tahboub

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1528410198
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016023495 Issued in MO
Practice address
2301 Holmes St
Kansas City, MO 64108-2640
Phone
(816) 404-4175
NPI assigned
Jul 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2016023495 MO Primary

Addresses

Primary practice location

2301 Holmes St
Kansas City, MO 64108-2640

Mailing address

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-4175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20230207000572 LA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 6002100260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1415 Tulane Ave
New Orleans, LA 70112-2600
Phone (504) 988-5800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Oct 26, 2022 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Oct 26, 2022 Accepting new patients

Locations

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1415 Tulane Ave
Fl 7
New Orleans, LA 70112
Phone (504) 988-5194

1430 Tulane Ave
#8509
New Orleans, LA 70112
Phone (504) 988-7517

Organizations & group practices 2

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 5

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1528410198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082640",
            "telephone_number": "816-404-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082640",
            "telephone_number": "816-404-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHBOUB",
        "first_name": "MOHAMMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2016023495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.