Individual provider Active NPI

Mohammed Dodwad, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ladysmith, WI
National Provider Identifier
1669407649
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
36597 Issued in WI
Practice address
900 College Ave W
Ladysmith, WI 54848-2116
Phone
(715) 532-5561
Fax
(715) 532-9809
NPI assigned
Jul 11, 2006
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 36597 WI Primary

Addresses

Primary practice location

900 College Ave W
Ladysmith, WI 54848-2116

Mailing address

5753 Dawley Dr
Fitchburg, WI 53711-7221
Phone (608) 276-9868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040128000433 WI Practitioner - Emergency MedicinePractitioner - Pathology 2860395936 Reassigns benefits to 1 organization
I20240814003082 IL Practitioner - Emergency Medicine 2860395936 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas H Boyd Memorial HospitalGroup PAC ID 8123085560, 30 clinicians

Practice addresses (Care Compare)

800 School St
Carrollton, IL 62016-1436
Phone (217) 942-6946

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas H. Boyd Memorial Hospital CurrentSince Nov 10, 2024 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Sep 1, 2016 Accepting new patients
Thomas H. Boyd Memorial Hospital Current Accepting new patients
Memorial Hospital of Boscobel CurrentSince Sep 1, 2016 Accepting new patients
Integritas Emergency Physician Services, LLC CurrentSince Jul 9, 2024 Accepting new patients
Thomas H. Boyd Memorial Hospital CurrentSince Nov 10, 2024 Accepting new patients
Marshfield Clinic Inc Past Accepting new patients

Locations

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

800 School St
Carrollton, IL 62016
Phone (217) 942-3600

611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

Organizations & group practices 7

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 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1669407649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5753 DAWLEY DR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117221",
            "telephone_number": "608-276-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COLLEGE AVE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548482116",
            "telephone_number": "715-532-5561",
            "fax_number": "715-532-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODWAD",
        "first_name": "MOHAMMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "36597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladysmith, WI

Sources for this page

Verify at the official NPI Registry.