Individual provider Active NPI

Mohamed Asem Zineddin, M.D.

  • Internal Medicine Physician
  • Florence, KY
National Provider Identifier
1659384865
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34848 Issued in KY
Practice address
8731 Bankers St Unit a
Florence, KY 41042-4240
Phone
(859) 282-8840
Fax
(859) 282-8830
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34848 KY Primary

Addresses

Primary practice location

8731 Bankers St Unit a
Florence, KY 41042-4240

Mailing address

1705 Savannah Lakes Dr
Florence, KY 41042-8681
Phone (859) 282-8840

Other identifiers 4

IdentifierTypeStateIssuer
64017817MedicaidKY
000000362482OtherKYANTHEM
030476360OtherKYUNITED HEALTH CARE
030476360OtherKYHUMANA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050713000909 KY Practitioner - Internal Medicine 6002880671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florence Urgent CareGroup PAC ID 8527227685, 2 clinicians

Practice addresses (Care Compare)

8820 Bankers St
Florence, KY 41042-4212
Phone (859) 647-1918

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34848KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Medical Group PSC Internal Medicine CurrentSince Oct 7, 2002 Accepting new patients
Florence Urgent Care Internal Medicine CurrentSince Jul 1, 2000 Accepting new patients
Lawrenceburg Urgent Care PastSince Sep 10, 2004 Accepting new patients

Locations

8820 Bankers St
Florence, KY 41042
Phone (859) 647-1918

8731 Bankers St
Unit A
Florence, KY 41042
Phone (859) 282-8840

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1659384865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 SAVANNAH LAKES DR",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410428681",
            "telephone_number": "859-282-8840",
            "fax_number": "859-282-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8731 BANKERS ST UNIT A",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424240",
            "telephone_number": "859-282-8840",
            "fax_number": "859-282-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINEDDIN",
        "first_name": "MOHAMED",
        "middle_name": "ASEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64017817",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000362482",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "030476360",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "030476360",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.