Active NPI
Sameh Nazeeh Adly Mohareb, MD, M.B.,BCH.
- Cardiovascular Disease Physician
- Tavares, FL
National Provider Identifier
1609162064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- ME144808
- Practice address
- 1825 Salk Ave
Tavares, FL 32778-4311 - Phone
- (352) 343-1158
- NPI assigned
- Jun 23, 2011
- Last updated
- Jun 12, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Cardiovascular Disease Physician | 207RC0000X | ME144808 | FL | Primary |
| Hospitalist Physician | 208M00000X | MD.207080 | LA |
Addresses
Primary practice location
1825 Salk Ave
Tavares, FL 32778-4311
Mailing address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000
Other practice location 1
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4135
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05000046 | Medicaid | MS | |
| 2370022 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1609162064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 JEFFERSON HWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701212429",
"telephone_number": "504-842-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 SALK AVE",
"city": "TAVARES",
"state": "FL",
"postal_code": "327784311",
"telephone_number": "352-343-1158"
}
],
"practiceLocations": [
{
"address_1": "1514 Jefferson Hwy",
"address_purpose": "LOCATION",
"city": "New Orleans",
"state": "LA",
"postal_code": "701212429",
"country_code": "US",
"telephone_number": "504-842-4135",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOHAREB",
"first_name": "SAMEH",
"middle_name": "NAZEEH ADLY",
"credential": "MD, M.B.,BCH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-23",
"last_updated": "2020-06-12",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "ME144808",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "LA",
"license": "MD.207080",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05000046",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2370022",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tavares, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.