NPIMap

Individual provider Active NPI

Mohammed M Al-Jasim, MD

  • Infectious Disease Physician
  • El Centro, CA
National Provider Identifier
1760479786
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A82827 Issued in CA
Practice address
1600 S Imperial Ave
Suite #8
El Centro, CA 92243-4242
Phone
(760) 336-3773
Fax
(760) 370-3229
NPI assigned
Oct 4, 2005
Last updated
Nov 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A82827 CA
Infectious Disease Physician 207RI0200X A82827 CA Primary

Addresses

Primary practice location

1600 S Imperial Ave
Suite #8
El Centro, CA 92243-4242

Mailing address

PO Box 3156
El Centro, CA 92244-3156
Phone (760) 336-3773

Other identifiers 1

IdentifierTypeStateIssuer
1760479786MedicaidCA

Other names 1

  • Mohammed Abdulridha Mohammed Former name

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
I20041008001302 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 1355300849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
On Call Specialists Medical Group of San Diego IncGroup PAC ID 7911395231, 145 clinicians

Practice addresses (Care Compare)

1600 S Imperial Ave
Suite 8
El Centro, CA 92243-4242
Phone (760) 336-3773

4077 5TH Ave
San Diego, CA 92103-2105
Phone (619) 359-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.37 of 100Reported as individual
Quality
56
Improvement activities
40
Cost
69.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue217

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82827CAMDAmbulatory Care Pharmacist
A82827CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohammed Al-Jasim MD a Medical Corporation Infectious Disease CurrentSince May 9, 2012 Accepting new patients
On Call Specialists Medical Group of San Diego, Inc. CurrentSince Aug 1, 2023 Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

1600 S Imperial Ave
Ste 8
El Centro, CA 92243
Phone (760) 336-3773

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

650 E Devon Ave
Ste 165
Itasca, IL 60143
Phone (630) 285-1040

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJCGBA/Endpoint/IJCGBA

Organizations & group practices 2

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 5

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1760479786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3156",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922443156",
            "telephone_number": "760-336-3773",
            "fax_number": "760-370-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S IMPERIAL AVE",
            "address_2": "SUITE #8",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434242",
            "telephone_number": "760-336-3773",
            "fax_number": "760-370-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-JASIM",
        "first_name": "MOHAMMED",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A82827",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A82827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760479786",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMED",
            "last_name": "MOHAMMED",
            "middle_name": "ABDULRIDHA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.