Active NPI
Mudasser Durraze Mohammed, MD
- Internal Medicine Physician
- Cincinnati, OH
National Provider Identifier
1871340117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 57.256273
- Practice address
- 4777 E Galbraith Rd
Cincinnati, OH 45236-2814 - Phone
- (513) 686-3000
- NPI assigned
- May 3, 2024
- Last updated
- May 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 57.256273 | OH | Primary |
Addresses
Primary practice location
4777 E Galbraith Rd
Cincinnati, OH 45236-2814
Mailing address
2643 Kilkenny CT
Springfield, OH 45503-1164
Phone (937) 561-0075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.256273 | OH | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1871340117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2643 KILKENNY CT",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455031164",
"telephone_number": "937-561-0075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4777 E GALBRAITH RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452362814",
"telephone_number": "513-686-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMMED",
"first_name": "MUDASSER",
"middle_name": "DURRAZE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-03",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "57.256273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.