Individual provider Active NPI

Firas Mahmood

  • Home Modifications Contractor
  • Westerville, OH
National Provider Identifier
1619339165
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
0135468 Issued in OH
Practice address
203 E. Schrock Rd.
Westerville, OH 43081
Phone
(614) 313-7374
Fax
(614) 427-5591
NPI assigned
Mar 23, 2016
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 0135468 OH Primary

Addresses

Primary practice location

203 E. Schrock Rd.
Westerville, OH 43081

Mailing address

203 E Schrock Rd
Westerville, OH 43081-3448
Phone (614) 313-7374

Other identifiers 1

IdentifierTypeStateIssuer
0135468MedicaidOH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0135468OHMDHome Modifications Contractor

Practice roles

OrganizationSpecialtyStatusNew patients
Black Bronco Construction Home Modifications Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1619339165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E SCHROCK RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430813448",
            "telephone_number": "614-313-7374",
            "fax_number": "614-427-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E. SCHROCK RD.",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "43081",
            "telephone_number": "614-313-7374",
            "fax_number": "614-427-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "FIRAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "OH",
            "license": "0135468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135468",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.