Individual provider Active NPI

Tami L Mohan, PA-C

  • Physician Assistant
  • Zanesville, OH
National Provider Identifier
1720088966
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50001155 Issued in OH
Practice address
2945 Maple Ave
Zanesville, OH 43701-1762
Phone
(740) 454-4712
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50001155 OH Primary

Addresses

Primary practice location

2945 Maple Ave
Zanesville, OH 43701-1762

Mailing address

945 Bethesda Dr Ste 200
Zanesville, OH 43701-1880
Phone (740) 454-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040728001556 OH Practitioner - Physician Assistant 7911977764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

945 Bethesda Dr
Zanesville, OH 43701-1880

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50001155OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group LLC CurrentSince Dec 1, 2008 Accepting new patients
Genesis Medical Group, LLC CurrentSince Dec 1, 2008 Accepting new patients
Genesis Professional Corp Past Accepting new patients
Genesis Healthcare System Past Accepting new patients

Locations

646 Chestnut St
Coshocton, OH 43812
Phone (740) 622-3370

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

800 Forest Ave
Zanesville, OH 43701
Phone (740) 454-0366

2945 Maple Ave
Zanesville, OH 43701
Phone (740) 454-0158

2945 Maple Ave
Ste 2B
Zanesville, OH 43701
Phone (740) 454-4712

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

751 Forest Ave
Ste 102
Zanesville, OH 43701
Phone (740) 454-4966

751 Forest Ave
Ste 200
Zanesville, OH 43701
Phone (740) 453-0548

Organizations & group practices 4

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1720088966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 BETHESDA DR STE 200",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011880",
            "telephone_number": "740-454-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011762",
            "telephone_number": "740-454-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "TAMI",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.