NPIMap

Individual provider Active NPI

Mohammad M. Dbeisi I, MD

  • Emergency Medicine Physician
  • Park City, UT
National Provider Identifier
1689686370
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
044334 Issued in CT
Practice address
900 Round Valley Dr
Park City, UT 84060
Phone
(801) 442-1702
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 044334 CT Primary

Addresses

Primary practice location

900 Round Valley Dr
Park City, UT 84060

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-6295

Other identifiers 1

IdentifierTypeStateIssuer
1689686370OtherUTNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060913000256 CT Practitioner - Emergency Medicine 9931103504 Reassigns benefits to 1 organization
I20130911000106 UT Practitioner - Emergency Medicine 9931103504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Connecticut School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

900 Round Valley Dr
Park City, UT 84060-7552
Phone (435) 658-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jul 1, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 25, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2026 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Current Accepting new patients
Ihc Health Services Inc CurrentSince Aug 25, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jul 1, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Waterbury Hospital Past Accepting new patients

Locations

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

900 Round Valley Dr
Park City, UT 84060
Phone (435) 658-7000

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

4646 W Lake Park Blvd
#3
West Valley City, UT 84120

Interoperability endpoints

  • Direct secure messaging: mohammad.dbeisi@xdr.hhchealthdirect.org
  • Direct secure messaging: mdbeisi@direct.wtbyhosp.org

Organizations & group practices 8

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 3

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1689686370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84060",
            "telephone_number": "801-442-1702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "64 Robbins St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067082613",
            "country_code": "US",
            "telephone_number": "203-573-6295",
            "fax_number": "203-573-7613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DBEISI",
        "first_name": "MOHAMMAD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "044334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689686370",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

Verify at the official NPI Registry.