Individual provider Active NPI

Mir Mohammad Tokir Mujtaba, MD

  • Cardiovascular Disease Physician
  • Lebanon, NH
National Provider Identifier
1578727178
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
20655 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5724
NPI assigned
Jul 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13464 RI
Internal Medicine Physician 207R00000X 51042 CT
Internal Medicine Physician 207R00000X C191530 CA
Cardiovascular Disease Physician 207RC0000X 20655 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

1426 University Ave Ste C
Riverside, CA 92507-4401
Phone (951) 522-1425

Other practice location 1

1426 University Ave Ste C
Riverside, CA 92507-4401
Phone (951) 522-1425

Other practice location 2

80 Seymour St
Hartford, CT 06106-3315
Phone (860) 545-5020

Other identifiers 1

IdentifierTypeStateIssuer
1578727178OtherCTMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NH, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150216000796 NC Practitioner - HospitalistPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8224226667 Reassigns benefits to 1 organization
I20200813001938 NH Practitioner - Cardiovascular Disease (Cardiology) 8224226667 Reassigns benefits to 2 organizations
I20260223002381 CA Practitioner - Internal Medicine 8224226667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1426 University Ave
Suite C
Riverside, CA 92507-4401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C191530CAMDInternal Medicine Physician
51042CTMDInternal Medicine Physician
20655NHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2020 Accepting new patients
Moses Cone Physician Services, Inc. Internal Medicine Current Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Vital Care Health Group a Medical Corporation CurrentSince Jan 10, 2026 Accepting new patients
Mount Sinai Hospice and Palliative Care Inc PastSince Nov 19, 2023 Accepting new patients

Locations

1426 University Ave
Ste C
Riverside, CA 92507
Phone (760) 696-7023

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: mmujtaba397313@direct.dartmouth-hitchcock.org

Organizations & group practices 6

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 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": "1215820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1578727178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 UNIVERSITY AVE STE C",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074401",
            "telephone_number": "951-522-1425",
            "fax_number": "951-900-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1426 University Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925074401",
            "country_code": "US",
            "telephone_number": "951-522-1425",
            "fax_number": "951-900-6169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063315",
            "country_code": "US",
            "telephone_number": "860-545-5020",
            "fax_number": "860-545-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUJTABA",
        "first_name": "MIR MOHAMMAD",
        "middle_name": "TOKIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-12",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD13464",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "51042",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C191530",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NH",
            "license": "20655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1578727178",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.