NPIMap

Individual provider Active NPI

Mohamed Bassam Sebai, M.D.

  • Specialist
  • Upland, CA
National Provider Identifier
1760481915
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A50851 Issued in CA
Practice address
1238 E Arrow Hwy
Upland, CA 91786-4951
Phone
(909) 982-0099
Fax
(909) 931-0402
NPI assigned
Jul 19, 2005
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A50851 CA Primary

Addresses

Primary practice location

1238 E Arrow Hwy
Upland, CA 91786-4951

Mailing address

1238 E Arrow Hwy
Upland, CA 91786-4951
Phone (909) 982-0099

Other identifiers 1

IdentifierTypeStateIssuer
GR0091870MedicaidCA

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
I20040708000332 CA Practitioner - RheumatologyPractitioner - Internal Medicine 7618955592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inland Rheumatology and Osteoporosis Medical Group IncGroup PAC ID 8224925748, 4 clinicians

Practice addresses (Care Compare)

1238 E Arrow Hwy
Upland, CA 91786-4951
Phone (909) 982-0099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50851CAMDOrthodontics and Dentofacial Orthopedic Dentist
A50851CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Rheumatology and Osteoporosis Medical Group Inc Specialist CurrentSince Sep 1, 2002 Accepting new patients
Primecare Medical Group Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients

Locations

1661 Hanover Rd
Ste 227
City of Industry, CA 91748
Phone (626) 233-2853

1238 E Arrow Hwy
Upland, CA 91786
Phone (909) 982-0099

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mbs104pcs@m986.primeclinicalsystems.direct-ci.com

Organizations & group practices 4

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1760481915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 E ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864951",
            "telephone_number": "909-982-0099",
            "fax_number": "909-931-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 E ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864951",
            "telephone_number": "909-982-0099",
            "fax_number": "909-931-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBAI",
        "first_name": "MOHAMED",
        "middle_name": "BASSAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A50851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.