Samar Mahmood, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036110009 Issued in IL

Practice address

12 Healh Services Drive
Dekalb, IL 60115

Phone

(815) 756-4875

Fax

(815) 787-9582

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Psychiatry

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dekalb Behavioral Health Foundation, Inc.Group PAC ID 9436451655, 20 clinicians

Conventions Psychiatry and Counseling PCGroup PAC ID 0143113027, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dekalb Behavioral Health Foundation, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dekalb, IL
  • NPI 1255703450
  Medicare reassignment Care Compare group NPD
• Conventions Psychiatry & Counseling, P.C.

  • Psychiatry Physician
  • Warrenville, IL
  • NPI 1053355289
  Medicare reassignment Care Compare group
• Dekalb Behavioral Health Foundation, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sandwich, IL
  • NPI 1487015194
  NPD
• Oak Forest Psychological Service

  • Clinical Psychologist
  • Countryside, IL
  • NPI 1265487060

  Psychiatry

  NPD (past)

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Kishwaukee Community Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1669545943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-787-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HEALH SERVICES DRIVE",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "60115",
            "telephone_number": "815-756-4875",
            "fax_number": "815-787-9582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 Wall St",
            "address_2": "Suite 304",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605631123",
            "country_code": "US",
            "telephone_number": "630-416-8289",
            "fax_number": "630-416-8306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "SAMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036110009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110009",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coresair Anton Mack
• Lorna K. Mackeben, RN,CNP
• Lauren Mackey, LPC
• Dawn Magnuson
• Shobha Mahadevan, M.D.
• Main Street Hearing
• Manjusri Majumdar, MD
• Katie Maki
• Carlos Maldonado Garcia, APRN, CNP
• Shannon Malik

• Psychiatry Physician in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.