Individual provider Active NPI

Mohammed Mamdouh Al-Qasmi, MD

  • Neurology Physician
  • Bay City, MI
National Provider Identifier
1629027479
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301075825 Issued in MI
Practice address
1900 Columbus Ave
Bay City, MI 48708-6831
Phone
(989) 667-3410
Fax
(989) 667-3411
NPI assigned
May 9, 2006
Last updated
Jan 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301075825 MI Primary

Addresses

Primary practice location

1900 Columbus Ave
Bay City, MI 48708-6831

Mailing address

1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 667-3410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050927000202 MI Practitioner - Neurology 9234163486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flint Neurological Centre PCGroup PAC ID 1759308620, 5 clinicians

Practice addresses (Care Compare)

5082 Villa Linde Pkwy
Flint, MI 48532-3411
Phone (810) 720-1335

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301075825MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jawad a Shah MD PC CurrentSince Feb 1, 2021 Accepting new patients
Complete Health Systems Inc CurrentSince Jan 1, 2017 Accepting new patients
Jawad a Shah, MD PC CurrentSince Feb 1, 2021 Accepting new patients
Flint Neurological Centre PC CurrentSince Jan 19, 2015 Accepting new patients

Locations

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

5082 Villa Linde Pkwy
Flint, MI 48532
Phone (810) 720-1335

Organizations & group practices 4

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.

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1629027479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086831",
            "telephone_number": "989-667-3410",
            "fax_number": "989-667-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086831",
            "telephone_number": "989-667-3410",
            "fax_number": "989-667-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-QASMI",
        "first_name": "MOHAMMED",
        "middle_name": "MAMDOUH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301075825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.