NPIMap

Individual provider Active NPI

Mohammad Shahid

  • Anatomic Pathology & Clinical Pathology Physician
  • Jacksonville, FL
National Provider Identifier
1720421902
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD2019-0535 Issued in NM
Practice address
655 W 8TH St
Dept. of Pathology- Ufcom- Jacksonville
Jacksonville, FL 32209-6511
Phone
(904) 244-4889
Fax
(904) 244-5565
NPI assigned
Apr 8, 2013
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Hematology (Pathology) Physician 207ZH0000X MD2019-0535 NM
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD2019-0535 NM Primary

Addresses

Primary practice location

655 W 8TH St
Dept. of Pathology- Ufcom- Jacksonville
Jacksonville, FL 32209-6511

Mailing address

640 Quantum Rd NE
Rio Rancho, NM 87124-4506
Phone (505) 924-0209

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address SRMC@direct.health.unm.edu
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20191108000112 NM Practitioner - Pathology 0547487308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2019-0535NMMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Dec 16, 2021 Accepting new patients
Presbyterian Healthcare Services CurrentSince Dec 16, 2021 Accepting new patients
Unm Medical Group, Inc. CurrentSince Nov 23, 2021 Accepting new patients
Unm Medical Group Inc CurrentSince Nov 23, 2021 Accepting new patients
Petroglyph Pathology Services, LLC Anatomic Pathology & Clinical Pathology PastSince Oct 20, 2019 Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140

301 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-7000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: mshahid275315@ahs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1720421902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 QUANTUM RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244506",
            "telephone_number": "505-924-0209",
            "fax_number": "505-924-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "DEPT. OF PATHOLOGY- UFCOM- JACKSONVILLE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4889",
            "fax_number": "904-244-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHID",
        "first_name": "MOHAMMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "NM",
            "license": "MD2019-0535",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "MD2019-0535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SRMC@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "3001 Broadmoor Blvd NE",
            "city": "Rio Rancho",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871442100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.