NPIMap

Individual provider Active NPI

Mohammed D Haider, M.D.

  • Nephrology Physician
  • Sault Sainte Marie, MI
National Provider Identifier
1760572002
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301087221 Issued in MI
Practice address
509 Osborn Blvd Ste 340
Sault Sainte Marie, MI 49783-2071
Phone
(906) 632-5824
Fax
(906) 632-5818
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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 4301087221 MI
Nephrology Physician 207RN0300X 4301087221 MI Primary

Addresses

Primary practice location

509 Osborn Blvd Ste 340
Sault Sainte Marie, MI 49783-2071

Mailing address

500 Osborn Blvd
Sault Sainte Marie, MI 49783-1822
Phone (906) 635-4654

Other identifiers 2

IdentifierTypeStateIssuer
4934104MedicaidMI
MH087221OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070117000309 MI Practitioner - NephrologyPractitioner - Internal Medicine 9133120116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians

Practice addresses (Care Compare)

146 E Spruce St
Sault Sainte Marie, MI 49783-1822
Phone (906) 253-0113

500 Osborn Blvd
Sault S Marie, MI 49783-1822

509 Osborn Blvd
Sault Sainte Marie, MI 49783-2069
Phone (906) 635-4401

509 Osborn Blvd
Sault Sainte Marie, MI 49783-2071

Hospital & facility affiliations

  • Chippewa Dialysis Services Dialysis facility, Sault Sainte Marie, MI, CCN 232350
  • Chippewa County War Memorial Hospital Hospital, Sault Ste Marie, MI, CCN 230239
  • Mackinac Straits Hospital and Health Center Hospital, Saint Ignace, MI, CCN 231306
  • Helen Newberry Joy Hospital Hospital, Newberry, MI, CCN 231304

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Sault CurrentSince May 10, 2014 Accepting new patients
Mymichigan Medical Center Sault Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince May 10, 2014 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Mymichigan Medical Center Sault PastSince Aug 2, 2020 Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

509 Osborn Blvd
Sault Sainte Marie, MI 49783
Phone (906) 253-2605

509 Osborn Blvd
Ste 340
Sault Sainte Marie, MI 49783
Phone (906) 632-5824

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

Interoperability endpoints

  • Direct secure messaging: mhaider143492@mymichiganhealth.midirect.net

Organizations & group practices 15

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.

View all 15

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1760572002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OSBORN BLVD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831822",
            "telephone_number": "906-635-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OSBORN BLVD STE 340",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832071",
            "telephone_number": "906-632-5824",
            "fax_number": "906-632-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDER",
        "first_name": "MOHAMMED",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301087221",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301087221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4934104",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "MH087221",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.