NPIMap

Individual provider Active NPI

Mushtaq Hussain Mohammed, M.D.

  • Hospitalist Physician
  • Bolingbrook, IL
National Provider Identifier
1700828563
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036114415 Issued in IL
Practice address
1000 Remington Blvd
Suite 200
Bolingbrook, IL 60440-5114
Phone
(630) 312-7755
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-114415 IL
Hospitalist Physician 208M00000X 036114415 IL Primary

Addresses

Primary practice location

1000 Remington Blvd
Suite 200
Bolingbrook, IL 60440-5114

Mailing address

1000 Remington Blvd
Suite 200
Bolingbrook, IL 60440-5114
Phone (630) 312-7755

Other identifiers 1

IdentifierTypeStateIssuer
036-114415MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000025 IL Practitioner - Internal Medicine 7810991247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Inpatient Medicine LLCGroup PAC ID 8022305697, 42 clinicians

Practice addresses (Care Compare)

500 Remington Blvd
Bolingbrook, IL 60440-4906
Phone (630) 312-5000

Hospital & facility affiliations

  • Uchicago Medicine Adventhealth Home Care Home health agency, La Grange, IL, CCN 147207
  • All American Home Care, Inc Home health agency, Palos Hills, IL, CCN 147758
  • Lighthouse Hospice Care LLC Hospice, Naperville, IL, CCN 141713
  • St Croix Hospice Des Plaines Hospice, Palos Heights, IL, CCN 141660
  • Lightways Hospice and Serious Illness Care Hospice, Joliet, IL, CCN 141539
  • Uchicago Medicine Adventhealth Bolingbrook Hospital, Bolingbrook, IL, CCN 140304
  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007
  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
  • Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
  • Meadowbrook Manor Nursing home, Bolingbrook, IL, CCN 145710

Merit-based Incentive Payment System (MIPS)

Final score
95.51 of 100Reported as group
Quality
93.25
Improvement activities
40
Cost
79.74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114415ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Inpatient Medicine LLC Hospitalist CurrentSince Oct 1, 2016 Accepting new patients
KND Development 59 LLC Hospitalist Current Accepting new patients
KND Development 59, LLC Hospitalist CurrentSince Oct 17, 2011 Accepting new patients
KND Development 59, LLC Hospitalist CurrentSince Oct 17, 2011 Accepting new patients
Midwest Neoped Associates LTD PastSince Jun 28, 2009 Accepting new patients

Locations

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

6130 N Sheridan Rd
Chicago, IL 60660
Phone (773) 381-1222

339 9th Ave
Lagrange Hlds, IL 60525
Phone (708) 354-4660

365 E North Ave
Northlake, IL 60164
Phone (517) 273-1540

903 Commerce Dr
Ste 333
Oak Brook, IL 60523
Phone (630) 571-6770

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

1131 W Jefferson St
Shorewood, IL 60404

Organizations & group practices 5

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 11

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1700828563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 200",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-312-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 200",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-312-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "MUSHTAQ",
        "middle_name": "HUSSAIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-114415",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036114415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-114415",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.