Individual provider Active NPI

Mohammad Elballat, M.D.

  • Pulmonary Disease Physician
  • Lakeland, FL
National Provider Identifier
1700129780
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME135268 Issued in FL
Practice address
3030 Harden Blvd
Lakeland, FL 33803-7952
Phone
(863) 687-1222
NPI assigned
Mar 28, 2013
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X ME135268 FL Primary

Addresses

Primary practice location

3030 Harden Blvd
Lakeland, FL 33803-7952

Mailing address

956 Court Ave Ste H314A
Memphis, TN 38103-2822
Phone (901) 448-5737

Other practice location 1

956 Court Ave Suite H314A
Memphis, TN 38163
Phone (901) 448-5735

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address melballat50601@LRHS.direct-ci.com Direct

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
I20221007001666 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7214282268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

3030 Harden Blvd
Lakeland, FL 33803-7952
Phone (863) 284-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. Pulmonary Disease CurrentSince Oct 1, 2022 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

2400 Kathleen Rd
Lakeland, FL 33810
Phone (863) 284-6800

3030 Harden Blvd
Lakeland, FL 33803
Phone (863) 687-1222

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: melballat50601@lrhs.direct-ci.com
  • Direct secure messaging: mohammad.elballat@hca4.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1700129780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 COURT AVE STE H314A",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032822",
            "telephone_number": "901-448-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037952",
            "telephone_number": "863-687-1222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "956 Court Ave Suite H314A",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38163",
            "country_code": "US",
            "telephone_number": "901-448-5735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELBALLAT",
        "first_name": "MOHAMMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME135268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melballat50601@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3030 Harden Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338037952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.