Mojahid Ali, MD
Individual provider Active NPI Vascular Surgery Physician · Jackson, TN
NPI 1821627910 · NPPES record last updated Jul 28, 2025
Key facts
- NPI
- 1821627910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- License
- 125.077346 (IL)
- Practice address
- 700 W Forest Ave FL 4
Jackson, TN 38301-3937 - Phone
- (731) 541-2250
- NPI assigned
- Apr 2, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Vascular Surgery
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Tennessee Medical Group Inc
Practice addresses (Care Compare)
700 W Forest Ave
4TH Floor
Jackson, TN 38301-3937
Phone (731) 541-3310
Hospital & facility affiliations
- Jackson-Madison County General Hospital
- Dyersburg Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250708001825 | TN | Practitioner - Vascular Surgery | 3274964689 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.077346 | IL | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Tennessee Medical Group Inc | Current |
Accepting new patients |
Locations
1718 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 285-5121
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
700 W Forest Ave
Fl 4
Jackson, TN 38301
Phone (731) 234-8736
257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283
700 W Forest Ave
Ste 4
Jackson, TN 38301
103A Jane St
Paris, TN 38242
405 Tyson Ave
Paris, TN 38242
Phone (731) 394-3499
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Vascular Surgery Physician | 2086S0129X | 125.077346 | IL | Yes |
Addresses
Primary practice location
700 W Forest Ave FL 4
Jackson, TN 38301-3937
Mailing address
257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 660-8759
Other practice location 1
701 N 1st St # D346
Springfield, IL 62702-3757
Phone (217) 545-8856
Other providers in Jackson, TN
- Susan Alexander
- Yolande Alexandre
- Hannah Grace Alford
- Hayden T Alford
- Mohsin T Alhaddad
- Mohammad Saeed Alkhatib
- Jeffery Hunter Allen
- Leanetta Allen
- Stephanie L Allen
- Tyler Allen
All providers in Jackson, TN · Vascular Surgery Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.