Individual provider Active NPI

Mohamed Sameh Teleb, M.D.

  • Vascular Neurology Physician
  • Mesa, AZ
National Provider Identifier
1750432035
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
49177 Issued in AZ
Practice address
1520 S Dobson Rd Ste 203
Mesa, AZ 85202-4726
Phone
(480) 412-8080
Fax
(480) 412-8081
NPI assigned
Jan 15, 2007
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 57384-20 WI
Vascular Neurology Physician 2084V0102X 57384-20 WI
Vascular Neurology Physician 2084V0102X 49177 AZ Primary

Addresses

Primary practice location

1520 S Dobson Rd Ste 203
Mesa, AZ 85202-4726

Mailing address

1520 S Dobson Rd Ste 203
Mesa, AZ 85202-4726
Phone (480) 412-8080

Other practice location 1

9200 W Wisconsin Ave
Department of Neurology
Milwaukee, WI 53226-3522
Phone (414) 805-3666

Other identifiers 1

IdentifierTypeStateIssuer
49177OtherAZARIZONA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140818000000 AZ Practitioner - NeurologyPractitioner - NeurosurgeryPractitioner - Other (Physician) 2668699521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Medical College of Wisconsin, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1400 S Dobson Rd
Banner Health Clinic
Mesa, AZ 85202-4707
Phone (480) 412-3000

1520 S Dobson Rd
Suite 206
Mesa, AZ 85202-4753
Phone (480) 412-8080

2225 W Southern Ave
Suite a
Mesa, AZ 85202-4716
Phone (623) 888-3502

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57384-20WIMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 1, 2014 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Mar 5, 2019 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 1, 2014 Accepting new patients
Banner-University Medical Group CurrentSince Mar 5, 2019 Accepting new patients

Locations

1520 S Dobson Rd
Ste 203
Mesa, AZ 85202
Phone (480) 412-8080

1520 S Dobson Rd
Ste 206
Mesa, AZ 85202
Phone (480) 412-8080

6553 E Baywood Ave
Ste 212
Mesa, AZ 85206
Phone (480) 543-6750

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

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 2

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1750432035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 203",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024726",
            "telephone_number": "480-412-8080",
            "fax_number": "480-412-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 203",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024726",
            "telephone_number": "480-412-8080",
            "fax_number": "480-412-8081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_2": "Department of Neurology",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-3666",
            "fax_number": "414-805-5252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELEB",
        "first_name": "MOHAMED",
        "middle_name": "SAMEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "57384-20",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "WI",
            "license": "57384-20",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "AZ",
            "license": "49177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL LICENSE",
            "identifier": "49177",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.