Individual provider Active NPI

Igbal Elamin Mohamed, PA

  • Medical Physician Assistant
  • Manchester, NH
National Provider Identifier
1639322332
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0695 Issued in NH
Practice address
145 Hollis St
Manchester, NH 03101-1235
Phone
(603) 626-9500
Fax
(603) 626-9523
NPI assigned
Oct 28, 2008
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0695 NH Primary

Addresses

Primary practice location

145 Hollis St
Manchester, NH 03101-1235

Mailing address

145 Hollis St
Manchester, NH 03101-1235
Phone (603) 626-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000537 NH Practitioner - Physician Assistant 1557403284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amoskeag HealthGroup PAC ID 8527038421, 30 clinicians

Practice addresses (Care Compare)

1245 Elm St
Manchester, NH 03101-1308
Phone (603) 626-9500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0695NHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Amoskeag Health CurrentSince Nov 29, 2009 Accepting new patients
Amoskeag Health CurrentSince Nov 29, 2009 Accepting new patients
Amoskeag Health Past Accepting new patients

Locations

1245 Elm St
Manchester, NH 03101
Phone (603) 668-6629

145 Hollis St
Manchester, NH 03101

145 Hollis St
Fl 2
Manchester, NH 03101

184 Tarrytown Rd
Manchester, NH 03103
Phone (603) 627-1102

88 McGregor St
Ste 302
Manchester, NH 03102
Phone (603) 622-8800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28516/brand/1/csg/1/fhir/r4
  • Direct secure messaging: igbal.mohamed.1@28516.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1639322332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500",
            "fax_number": "603-626-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500",
            "fax_number": "603-626-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "IGBAL",
        "middle_name": "ELAMIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.