NPIMap

Individual provider Active NPI

Ronnie A Mohammed, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Lebanon, PA
National Provider Identifier
1669463774
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD417333 Issued in PA
Practice address
755 Norman Drive
Lebanon, PA 17042-7497
Phone
(717) 273-6706
Fax
(717) 273-1435
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 002294 NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD417333 PA Primary

Addresses

Primary practice location

755 Norman Drive
Lebanon, PA 17042-7497

Mailing address

755 Norman Drive
Lebanon, PA 17042-7497
Phone (717) 273-6706

Other identifiers 3

IdentifierTypeStateIssuer
1021263630001MedicaidPA
2054072OtherHIGHMARK BLS
50078092OtherPACAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080903000054 PA Practitioner - EndocrinologyPractitioner - Internal Medicine 7618905381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

755 Norman Dr
Lebanon, PA 17042-7497
Phone (717) 273-6706

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002294NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lebanon Internal Medicine Associates PC CurrentSince Aug 18, 2008 Accepting new patients
Lebanon Internal Medicine Associates, P.C. Internal Medicine CurrentSince Aug 18, 2008 Accepting new patients

Locations

755 Norman Dr
Lebanon, PA 17042
Phone (717) 273-6706

Interoperability endpoints

  • Direct secure messaging: rmohammed@lima.medentdirect.com

Organizations & group practices 2

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1669463774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 NORMAN DRIVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427497",
            "telephone_number": "717-273-6706",
            "fax_number": "717-273-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 NORMAN DRIVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427497",
            "telephone_number": "717-273-6706",
            "fax_number": "717-273-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "RONNIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "002294",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD417333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021263630001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLS",
            "identifier": "2054072",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50078092",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.