NPIMap

Individual provider Active NPI

Mohammed Abbas Momin, M.D.

  • Vascular & Interventional Radiology Physician
  • Cartersville, GA
National Provider Identifier
1710327564
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
83111 Issued in GA
Practice address
960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone
(678) 905-7053
NPI assigned
Jun 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 83111 GA
Vascular & Interventional Radiology Physician 2085R0204X 83111 GA Primary

Addresses

Primary practice location

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129

Mailing address

PO Box 200096
Cartersville, GA 30120-9002
Phone (678) 905-7053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191007000171 GA Practitioner - Diagnostic Radiology 5890921274 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Meharry Medical College School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Imaging Services LLCGroup PAC ID 9436597945, 71 clinicians
Summit Radiology Services P CGroup PAC ID 3577454024, 70 clinicians

Practice addresses (Care Compare)

145 E Peacock St
Cochran, GA 31014-7846
Phone (478) 934-6211

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (770) 382-1530

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83111GAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Imaging Center CurrentSince Jun 1, 2022 Accepting new patients
Summit Imaging Services LLC Diagnostic Radiology CurrentSince Mar 20, 2024 Accepting new patients
Summit Radiology Services P C Diagnostic Radiology CurrentSince Aug 14, 2019 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Tanner Medical Group Inc PastSince Jun 1, 2022 Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

706 Dixie St
Ste 100
Carrollton, GA 30117
Phone (770) 812-8614

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

Organizations & group practices 6

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 5

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1710327564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200096",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301209002",
            "telephone_number": "678-905-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOE FRANK HARRIS PKWY SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202129",
            "telephone_number": "678-905-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "MOHAMMED ABBAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "83111",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "83111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.