NPIMap

Individual provider Active NPI

Mohammad Ismail, MD

  • Nephrology Physician
  • Paramount, CA
National Provider Identifier
1730105784
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A45544 Issued in CA
Practice address
16415 Colorado Ave
Suite 207
Paramount, CA 90723-5035
Phone
(562) 602-2334
Fax
(562) 602-0931
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A45544 CA Primary

Addresses

Primary practice location

16415 Colorado Ave
Suite 207
Paramount, CA 90723-5035

Mailing address

16415 Colorado Ave
Suite 207
Paramount, CA 90723-5035
Phone (562) 602-2334

Other identifiers 2

IdentifierTypeStateIssuer
00A455440MedicaidCA
W20647OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070320000297 CA Practitioner - NephrologyPractitioner - Internal Medicine 8426151085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Kidney Consultants IncGroup PAC ID 6103811286, 21 clinicians

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 211
Garden Grove, CA 92843-1916
Phone (714) 636-2890

Hospital & facility affiliations

  • Rai - Hospital Circle - Westminster Dialysis facility, Westminster, CA, CCN 052772
  • DaVita Anaheim Springs Dialysis Dialysis facility, Anaheim, CA, CCN 552766
  • DaVita Anaheim West Dialysis Dialysis facility, Anaheim, CA, CCN 552676
  • Fresenius Medical Care Anaheim Dialysis Dialysis facility, Anaheim, CA, CCN 552786
  • Fresenius Medical Care Dialysis Services North Orange County Dialysis facility, Anaheim, CA, CCN 052862
  • Quality Home Health Care, Inc Home health agency, Covina, CA, CCN 557478
  • Ahmc Anaheim Regional Medical Center Hospital, Anaheim, CA, CCN 050226
  • Uci Health-Lakewood Hospital, Lakewood, CA, CCN 050581
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

National Provider Directory

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

Practice roles (9 of 10)

OrganizationSpecialtyStatusNew patients
Southern California Kidney Consultants Inc. Nephrology CurrentSince May 1, 2021 Accepting new patients
Mohammad Ismail MD Inc Nephrology CurrentSince Mar 20, 2007 Accepting new patients
University of California Irvine Past Accepting new patients
Coast Plaza Doctors Hospital Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients

Locations

1801 W Romneya Dr
Ste 104
Anaheim, CA 92801
Phone (714) 678-4000

1801 W Romneya Dr
Ste 409
Anaheim, CA 92801
Phone (714) 772-8282

1019 W La Palma Ave
Unit A
Anaheim, CA 92801
Phone (714) 364-4441

12665 Garden Grove Blvd
Ste 211
Garden Grove, CA 92843
Phone (714) 636-2890

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

16415 Colorado Ave
Ste 207
Paramount, CA 90723
Phone (562) 602-2334

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21072/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mismailmd17267@direct.memorialcare.org
  • Direct secure messaging: mohammad.ismail.1@21072.direct.athenahealth.com

Organizations & group practices 9

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 10

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1730105784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16415 COLORADO AVE",
            "address_2": "SUITE 207",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235035",
            "telephone_number": "562-602-2334",
            "fax_number": "562-602-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16415 COLORADO AVE",
            "address_2": "SUITE 207",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235035",
            "telephone_number": "562-602-2334",
            "fax_number": "562-602-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A45544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A455440",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W20647",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramount, CA

Sources for this page

Verify at the official NPI Registry.