Mohammad Baghaei-Rad
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Amsterdam, NY
NPI 1649256173 · NPPES record last updated Aug 13, 2007
Key facts
- NPI
- 1649256173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 036328 (NY)
- Practice address
- 5010 State Hwy 30
Ste 203
Amsterdam, NY 12010 - Phone
- (518) 842-9850
- Fax
- (518) 842-3854
- NPI assigned
- Dec 16, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 23, 2016 through Mar 23, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036328 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 036328 | NY | Yes |
Addresses
Primary practice location
5010 State Hwy 30
Ste 203
Amsterdam, NY 12010
Mailing address
5010 State Hwy 30
Ste 203
Amsterdam, NY 12010
Phone (518) 842-9850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00756565 | Medicaid | NY | |
| 32685 | Other | MVP | |
| 0004240 | Other | DORAL |
Other providers in Amsterdam, NY
- Lemuel Perez Arriola
- Associates in Rehabilitation Technology, Inc
- Paul Austin
- Amylynn Avery
- B.M.S. Medical Equipment LLC
- Brij Kishan Bajaj
- Joshua Reid Baker
- Margaret Ballantine
- Kelsi Barnholt
- Calixto M Barrueco
All providers in Amsterdam, NY · Oral and Maxillofacial Surgery (Dentist) in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.