Individual provider Active NPI

Mohammad Fareed, MD

  • Internal Medicine Physician
  • Wauwatosa, WI
National Provider Identifier
1841229044
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38319 Issued in WI
Practice address
2727 N Mayfair Rd
Suite I
Wauwatosa, WI 53222-4400
Phone
(414) 773-6300
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38319 WI Primary

Addresses

Primary practice location

2727 N Mayfair Rd
Suite I
Wauwatosa, WI 53222-4400

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 773-6300

Other identifiers 1

IdentifierTypeStateIssuer
32329000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051123000100 WI Practitioner - Internal Medicine 1557381399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians
Wisconsin Health FundGroup PAC ID 3072401298, 27 clinicians

Practice addresses (Care Compare)

10950 W Capitol Dr
Wauwatosa, WI 53222-1110
Phone (414) 464-4460

13950 W Capitol Dr
Brookfield, WI 53005-2441
Phone (414) 464-4460

6200 W Bluemound Rd
Milwaukee, WI 53213-4145
Phone (414) 771-5600

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38319WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Nov 1, 2005 Accepting new patients
Wisconsin Health Fund CurrentSince Oct 1, 2001 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Nov 1, 2005 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients
Wisconsin Health Fund Past Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients

Locations

8430 W Capitol Dr
Ste 103CB
Milwaukee, WI 53222
Phone (414) 464-1000

6200 W Bluemound Rd
Milwaukee, WI 53213
Phone (414) 479-3668

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

2727 N Mayfair Rd
Ste I
Wauwatosa, WI 53222
Phone (262) 754-2909

10950 W Capitol Dr
Wauwatosa, WI 53222
Phone (414) 464-4460

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1841229044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-773-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N MAYFAIR RD",
            "address_2": "SUITE I",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224400",
            "telephone_number": "414-773-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAREED",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "38319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32329000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.