Individual provider Active NPI

Mohamed Iqbal, MD

  • Anesthesiology Physician
  • Belleville, IL
National Provider Identifier
1659401396
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
36082644 Issued in IL
Practice address
28 N 64TH St
Belleville, IL 62223-3808
Phone
(908) 653-9399
Fax
(908) 653-9305
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 36082644 IL Primary

Addresses

Primary practice location

28 N 64TH St
Belleville, IL 62223-3808

Mailing address

PO Box 822344
Philadelphia, PA 19182-2344
Phone (314) 991-0985

Other identifiers 1

IdentifierTypeStateIssuer
36082644OtherILMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090402000049 MO Practitioner - Anesthesiology 4183795073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aim Anesthesia LLCGroup PAC ID 3971896705, 14 clinicians

Practice addresses (Care Compare)

3550 McKelvey Rd
Bridgeton, MO 63044-2527
Phone (314) 741-0911

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36082644ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SW Anesthesia LLC Anesthesiology CurrentSince Mar 26, 2019 Accepting new patients
Midwest Anesthesia Anesthesiology PastSince Jan 1, 1990 Accepting new patients
Gateway Anesthesia Group LLC Anesthesiology Past Accepting new patients
Midwest Anesthesia LLC Anesthesiology PastSince Jan 1, 1990 Accepting new patients

Locations

12345 W Bend Dr
Ste 201
Saint Louis, MO 63128
Phone (314) 722-2530

Organizations & group practices 5

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.

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1659401396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822344",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191822344",
            "telephone_number": "314-991-0985",
            "fax_number": "908-653-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 N 64TH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233808",
            "telephone_number": "908-653-9399",
            "fax_number": "908-653-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "36082644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "36082644",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.