Urooj Mujtaba, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1096688 Issued in OH

Practice address

4750 Hempstead Station Drive
Kettering, OH 45429

Phone

(800) 875-0136

Fax

(937) 619-4150

NPI assigned

Jul 14, 2011

Last updated

Oct 3, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment Care Compare group
• Galion Emergency Physicians Inc

  • Emergency Medicine Physician
  • Galion, OH
  • NPI 1457391187
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Marion General Hospital Foundation, Inc.

  dba Marion General Hospital Foundation, Inc./Marion General Hospital

  • Emergency Medicine Physician
  • Marion, OH
  • NPI 1134114077
  NPD (past)
• Marion Physician Billing LLC

  • Emergency Medicine Physician
  • Marion, OH
  • NPI 1013247568
  NPD (past)
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)
• Ohio Emergency Professionals Inc

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1982983425

  Physician Assistant

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1740578590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337C W NORTH AVE",
            "city": "ADA",
            "state": "OH",
            "postal_code": "458101801",
            "telephone_number": "650-743-9005",
            "fax_number": "937-619-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DRIVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUJTABA",
        "first_name": "UROOJ",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "1096688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morrow County Emergency Physicians Inc
• Ronald Joseph Moser, MD
• Leila Moudjed
• Hind N Moussa, MD
• Mr Prescription of Kettering Inc (Clarks Mr Prescription)
• Divine Mukamisha
• Bradford J Murphy, DO
• Cristina Michelle Murphy, FNP
• Elizabeth Marie Murphy, NP
• Thomas Reyes Murphy, M.D.

• Physician Assistant in Kettering, OH
• Providers in Kettering, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.