Active NPI
Daoud Ikhlas Mohamed, MSOT, OTR/L
- Occupational Therapist
- Queens Village, NY
National Provider Identifier
1669092920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024654
- Practice address
- 20613 104TH Ave
Queens Village, NY 11429-1024 - Phone
- (347) 458-1428
- NPI assigned
- Apr 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024654 | NY | Primary |
Addresses
Primary practice location
20613 104TH Ave
Queens Village, NY 11429-1024
Mailing address
20613 104TH Ave
Queens Village, NY 11429-1024
Phone (347) 458-1428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024654 | NY | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1669092920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20613 104TH AVE",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114291024",
"telephone_number": "347-458-1428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20613 104TH AVE",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114291024",
"telephone_number": "347-458-1428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMED",
"first_name": "DAOUD",
"middle_name": "IKHLAS",
"name_prefix": "Mr.",
"credential": "MSOT, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-16",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.