NPIMap

Individual provider Active NPI

Mohammad Othman, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
National Provider Identifier
1841678240
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301086478 Issued in MI
Practice address
5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone
(800) 288-8332
Fax
(419) 866-5453
NPI assigned
May 18, 2015
Last updated
May 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301086478 MI Primary

Addresses

Primary practice location

5700 Southwyck Blvd
Toledo, OH 43614-1509

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150609000182 MI Practitioner - Pathology 7012238637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Henry Ford PathologyGroup PAC ID 6406953439, 47 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System CurrentSince Aug 28, 2018 Accepting new patients
Port Huron Physicians Medical Group PC CurrentSince Sep 1, 2015 Accepting new patients
Henry Ford Pathology Anatomic Pathology & Clinical Pathology CurrentSince Sep 30, 2019 Accepting new patients
Henry Ford Health System CurrentSince Aug 28, 2018 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-4316

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

4190 24th Ave
Ste 208
Fort Gratiot, MI 48059
Phone (810) 216-4000

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

2601 Electric Ave
Port Huron, MI 48060
Phone (810) 216-1500

Interoperability endpoints

  • Direct secure messaging: mothman544286@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1841678240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8332",
            "fax_number": "419-866-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "MOHAMMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301086478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.