NPIMap

Individual provider Active NPI

Ethar Hassab E. B. Mohammed, MD, MPH

  • Infectious Disease Physician
  • Shreveport, LA
National Provider Identifier
1760972590
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
59820 Issued in KY
Practice address
1501 Kings Highway
Infectious Diseases
Shreveport, LA 71130
Phone
(318) 626-0506
NPI assigned
May 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X 59820 KY Primary

Addresses

Primary practice location

1501 Kings Highway
Infectious Diseases
Shreveport, LA 71130

Mailing address

1501 Kings Highway
Infectious Diseases
Shreveport, LA 71130
Phone (318) 626-0506

Other practice location 1

200 Abraham Flexner Way Ste 905
Louisville, KY 40202-2877
Phone (502) 589-4267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20241120001351 KY Practitioner - Infectious Disease 3072048636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Abraham Flexner Way
Louisville, KY 40202-1886
Phone (502) 587-4401

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

200 Abraham Flexner Way
Ste 905
Louisville, KY 40202
Phone (502) 589-4267

Organizations & group practices 3

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1760972590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HIGHWAY",
            "address_2": "INFECTIOUS DISEASES",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-626-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HIGHWAY",
            "address_2": "INFECTIOUS DISEASES",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-626-0506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Abraham Flexner Way Ste 905",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402022877",
            "country_code": "US",
            "telephone_number": "502-589-4267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "ETHAR",
        "middle_name": "HASSAB E. B.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-17",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "59820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.