Individual provider Active NPI

Humza Bin Waheed, M.D.

  • General Practice Physician
  • Mexico, MO
National Provider Identifier
1689938524
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2015027597 Issued in MO
Practice address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone
(573) 582-1234
Fax
(573) 581-1981
NPI assigned
Jun 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2015027597 MO Primary

Addresses

Primary practice location

340 Kelley Pkwy
Mexico, MO 65265-3811

Mailing address

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Other identifiers 1

IdentifierTypeStateIssuer
1689938524MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20150928001739 MO Practitioner - General Practice 2567696784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Saint Louis University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015027597MOMDGeneral Practice Physician

Interoperability endpoints

  • Direct secure messaging: humza.waheed@direct.arthurcenter.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arthur Center Behavioral HealthFulton, MO, CCN 261166 Federally qualified health center Corporate Officer
Operational/Managerial Control
May 15, 2016
May 15, 2016
Arthur Center Behavioral HealthMontgomery City, MO, CCN 791143 Federally qualified health center W-2 Managing Employee Sep 24, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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 4

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1689938524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-581-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-581-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHEED",
        "first_name": "HUMZA",
        "middle_name": "BIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2015027597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689938524",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mexico, MO

Sources for this page

Verify at the official NPI Registry.