Individual provider Active NPI

Mohammed Nadeem Ahmed, MD, PHD

  • Pediatrics Physician
  • Urbana, IL
National Provider Identifier
1841240322
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036114258 Issued in IL
Practice address
1109 S Lincoln Ave
Urbana, IL 61801-4703
Phone
(217) 333-2700
NPI assigned
May 12, 2006
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036114258 IL Primary

Addresses

Primary practice location

1109 S Lincoln Ave
Urbana, IL 61801-4703

Mailing address

2504 Waterville Dr
Champaign, IL 61822-7416
Phone (217) 418-4381

Other identifiers 2

IdentifierTypeStateIssuer
036114258MedicaidIL
6447860011MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20060105000565 IL Practitioner - Pediatric MedicinePractitioner - Hospitalist 1658394614 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036114258ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Apr 1, 2010 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Mar 18, 2019 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Mar 18, 2019 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Oct 25, 2023 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Oct 25, 2023 Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

810 W Anthony Dr
Urbana, IL 61802
Phone (217) 326-2911

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1841240322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 WATERVILLE DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618227416",
            "telephone_number": "217-418-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S LINCOLN AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618014703",
            "telephone_number": "217-333-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MOHAMMED",
        "middle_name": "NADEEM",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036114258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114258",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6447860011",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.