Individual provider Active NPI

Mohamed S. Khodeir, M.D.

  • Psychiatry Physician
  • Columbus, OH
National Provider Identifier
1801843024
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.146058 Issued in OH
Practice address
1301 N High St
Columbus, OH 43201-2460
Phone
(614) 299-6600
Fax
(614) 421-3111
NPI assigned
May 31, 2006
Last updated
Feb 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.146058 OH Primary
Psychiatry Physician 2084P0800X 36010 KY

Addresses

Primary practice location

1301 N High St
Columbus, OH 43201-2460

Mailing address

1301 N High St
Columbus, OH 43201-2460
Phone (614) 299-6600

Other identifiers 1

IdentifierTypeStateIssuer
64023849MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040428000166 KY Practitioner - Psychiatry 6002803483 Reassigns benefits to 1 organization
Practice locations: Louisville, KY
I20230309002349 OH Practitioner - Psychiatry 6002803483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Central Mental Health Services, Inc.Group PAC ID 5193612539, 10 clinicians

Practice addresses (Care Compare)

1301 N High St
Columbus, OH 43201-2460
Phone (614) 299-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36010KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Behavioral Health Systems PLLC Psychiatry CurrentSince Nov 22, 2011 Accepting new patients
North Central Mental Health Services, Inc. CurrentSince Feb 24, 2023 Accepting new patients
Deaconess Cross Pointe Past Accepting new patients
Kentuckyone Health Medical Group, Inc. Psychiatry Past Accepting new patients
Park View Psychiatric Services, PSC Past Accepting new patients
Deaconess Cross Pointe Center, LLC Past Accepting new patients
Dr Charles Bensenhaver III LLC PastSince Jan 31, 2023 Accepting new patients

Locations

3430 Newburg Rd
Ste 210
Louisville, KY 40218
Phone (502) 225-4900

1301 N High St
Columbus, OH 43201
Phone (614) 299-6600

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1801843024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012460",
            "telephone_number": "614-299-6600",
            "fax_number": "614-421-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012460",
            "telephone_number": "614-299-6600",
            "fax_number": "614-421-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODEIR",
        "first_name": "MOHAMED",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.146058",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "36010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64023849",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.