Mohammed Dodwad, MD
Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Ladysmith, WI
NPI 1669407649 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1669407649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- License
- 36597 (WI)
- Practice address
- 900 College Ave W
Ladysmith, WI 54848-2116 - Phone
- (715) 532-5561
- Fax
- (715) 532-9809
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Thomas H Boyd Memorial Hospital
Practice addresses (Care Compare)
800 School St
Carrollton, IL 62016-1436
Phone (217) 942-6946
Hospital & facility affiliations
- Fayette County Hospital
- Thomas H Boyd Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040128000433 | WI | Practitioner - Emergency Medicine |
2860395936 | Reassigns benefits to 1 organization |
| I20240814003082 | IL | Practitioner - Emergency Medicine | 2860395936 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital of Boscobel | Current |
Accepting new patients | |
| Thomas H. Boyd Memorial Hospital | Current |
Accepting new patients | |
| Integritas Emergency Physician Services, LLC | Current |
Accepting new patients | |
| Thomas H. Boyd Memorial Hospital | Current |
Accepting new patients | |
| Memorial Hospital of Boscobel | Current |
Accepting new patients | |
| Thomas H. Boyd Memorial Hospital | Current | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 36597 | WI | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33310900 | Medicaid | WI |
Other providers in Ladysmith, WI
- D & M Home Care, Inc.
- Callie Francine Darrow
- Joel D. Dekrey
- Dennis Deziel
- Abbey J Dieckman
- Donohue Chiropractic LTD
- Jenafer Marie Donohue
- Neil Thomas Donohue
- Thomas P. Donohue
- Dr Stephen Reisner Dentistry SC
All providers in Ladysmith, WI · Emergency Medical Services (Emergency Medicine) Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.