Individual provider Active NPI

Mohammed M Tamim, MD

  • Neonatal-Perinatal Medicine Physician
  • Dover, OH
National Provider Identifier
1669401592
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
35.087070 Issued in OH
Practice address
659 Boulevard St
Dover, OH 44622-2026
Phone
(440) 242-1001
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 1340 VI
Neonatal-Perinatal Medicine Physician 2080N0001X 35.087070 OH Primary

Addresses

Primary practice location

659 Boulevard St
Dover, OH 44622-2026

Mailing address

2860 Waterfall Way
Westlake, OH 44145-6847
Phone (440) 554-1431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100921000007 OH Practitioner - Pediatric Medicine 9638294135 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1340VIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children'S Hospital Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 26, 2024 Accepting new patients
Cleveland Clinic Mercy Hospital Past Accepting new patients
The Union Hospital Association Past Accepting new patients
Akron General Medical Center Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311

Interoperability endpoints

  • Direct secure messaging: mtamim41653@direct.chmca.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1669401592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 WATERFALL WAY",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441456847",
            "telephone_number": "440-554-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 BOULEVARD ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222026",
            "telephone_number": "440-242-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMIM",
        "first_name": "MOHAMMED",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VI",
            "license": "1340",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OH",
            "license": "35.087070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.