Individual provider Active NPI

Darayes S. Mobed, M.D

  • Specialist
  • Clewiston, FL
National Provider Identifier
1699776443
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME20848 Issued in FL
Practice address
540 W. Sagamore Avenue
Building D
Clewiston, FL 33440-3514
Phone
(863) 983-5026
Fax
(863) 983-2793
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125186 NY
Specialist 174400000X ME20848 FL Primary

Addresses

Primary practice location

540 W. Sagamore Avenue
Building D
Clewiston, FL 33440-3514

Mailing address

540 W. Sagamore Avenue
Building D
Clewiston, FL 33440-3514
Phone (863) 983-5026

Other identifiers 1

IdentifierTypeStateIssuer
280857900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080415000398 FL Practitioner - General Surgery 1153409271 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME20848FLMDSpecialist
125186NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hendry County Hospital Authority CurrentSince Mar 15, 2008 Accepting new patients
Hendry County Hospital Authority Specialist Current Accepting new patients
Hendry County Hospital Authority Past Accepting new patients

Locations

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

500 W Sagamore Ave
Clewiston, FL 33440
Phone (863) 902-3032

540 W Sagamore Ave
Bldg D
Clewiston, FL 33440
Phone (863) 983-5026

540 W Sagamore Ave
Clewiston, FL 33440
Phone (863) 983-5023

450 S Main St
Ste 1
Labelle, FL 33935
Phone (863) 675-2356

Interoperability endpoints

  • Direct secure messaging: lmcdmobed@yourcarecommunity.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1699776443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W. SAGAMORE AVENUE",
            "address_2": "BUILDING D",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403514",
            "telephone_number": "863-983-5026",
            "fax_number": "863-983-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W. SAGAMORE AVENUE",
            "address_2": "BUILDING D",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403514",
            "telephone_number": "863-983-5026",
            "fax_number": "863-983-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBED",
        "first_name": "DARAYES",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "125186",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME20848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280857900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clewiston, FL

Sources for this page

Verify at the official NPI Registry.