Individual provider Active NPI

Mohamad Nasr

  • Secured Medical Transport (VAN)
  • Millbrae, CA
National Provider Identifier
1770313652
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Secured Medical Transport (VAN)Taxonomy code 343800000X
License
BL-020749 Issued in CA
Practice address
394 Richmond Dr
Millbrae, CA 94030-1749
Phone
(650) 379-5924
NPI assigned
Aug 5, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Secured Medical Transport (VAN) 343800000X BL020749 CA
Secured Medical Transport (VAN) 343800000X BL-020749 CA Primary

Addresses

Primary practice location

394 Richmond Dr
Millbrae, CA 94030-1749

Mailing address

2342 Shattuck Ave
Berkeley, CA 94704-1517
Phone (656) 503-7959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BL-020749CAMDSecured Medical Transport (VAN)
BL020749CAMDSecured Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Emt Health Voyage Medical Transportation LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1770313652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041517",
            "telephone_number": "656-503-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 RICHMOND DR",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301749",
            "telephone_number": "650-379-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR",
        "first_name": "MOHAMAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "CA",
            "license": "BL020749",
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "CA",
            "license": "BL-020749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.