NPIMap

Individual provider Active NPI

Mohammad Tahir Farooq, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Conshohocken, PA
National Provider Identifier
1659302123
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD054264L Issued in PA
Practice address
100 Front St Ste 280
Conshohocken, PA 19428-2891
Phone
(484) 351-8459
Fax
(484) 351-8810
NPI assigned
Jul 5, 2006
Last updated
Sep 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD054264L PA Primary
Electrodiagnostic Medicine Physician 204R00000X MD054264L PA

Addresses

Primary practice location

100 Front St Ste 280
Conshohocken, PA 19428-2891

Mailing address

908 Rainbow Dr
Bethlehem, PA 18017-2333

Other practice location 1

225 Erdman St
Bangor, PA 18013-2043
Phone (610) 588-2225

Other identifiers 1

IdentifierTypeStateIssuer
01543270MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060201000071 PA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 5799799581 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wildcat Neurophysiology, PCGroup PAC ID 4789943804, 22 clinicians
Evokes LLCGroup PAC ID 4880983832, 19 clinicians
Yankee Neurophysiology PCGroup PAC ID 5698929883, 10 clinicians
Titan Neurophysiology PAGroup PAC ID 7113160433, 15 clinicians
American Intraoperative Monitoring LLCGroup PAC ID 8527230333, 16 clinicians

Practice addresses (Care Compare)

908 Rainbow Dr
Bethlehem, PA 18017-2333
Phone 4843518459202

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wildcat Neurophysiology, PC Electrodiagnostic Medicine CurrentSince Jan 1, 2022 Accepting new patients
Yankee Neurophysiology, P.C. Electrodiagnostic Medicine CurrentSince Feb 19, 2013 Accepting new patients
Evokes, LLC Electrodiagnostic Medicine CurrentSince Sep 26, 2017 Accepting new patients
Titan Neurophysiology PA Electrodiagnostic Medicine CurrentSince Dec 5, 2015 Accepting new patients
American Intraoperative Monitoring LLC Electrodiagnostic Medicine CurrentSince Jun 11, 2023 Accepting new patients
Maxime G Gedeon MD PC Past Accepting new patients

Locations

8118 Corporate Way
Ste 212
Mason, OH 45040
Phone (513) 947-8433

100 Front St
Ste 280
West Cnshohocken, PA 19428
Phone (215) 860-0100

1141 N Loop 1604 E
Ste 105
San Antonio, TX 78232
Phone (210) 338-6328

1141 N Loop 1604 E
Ste 105484
San Antonio, TX 78232

Organizations & group practices 6

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1659302123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 RAINBOW DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180172333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FRONT ST STE 280",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282891",
            "telephone_number": "484-351-8459",
            "fax_number": "484-351-8810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Erdman St",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "PA",
            "postal_code": "180132043",
            "country_code": "US",
            "telephone_number": "610-588-2225",
            "fax_number": "610-588-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAROOQ",
        "first_name": "MOHAMMAD",
        "middle_name": "TAHIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD054264L",
            "primary": true
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "PA",
            "license": "MD054264L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01543270",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conshohocken, PA

Sources for this page

Verify at the official NPI Registry.