Individual provider Active NPI

Eslam Mohamed, DO

  • Family Medicine Physician
  • Brandon, FL
National Provider Identifier
1881220846
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS18775 Issued in FL
Practice address
621 W Brandon Blvd
Brandon, FL 33511-5005
Phone
(813) 681-5702
NPI assigned
Mar 20, 2020
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A21465 CA
Family Medicine Physician 207Q00000X UO7323 FL
Family Medicine Physician 207Q00000X U1726 TX
Family Medicine Physician 207Q00000X 010271 AZ
Family Medicine Physician 207Q00000X 5101027533 MI
Family Medicine Physician 207Q00000X 036.163210 IL
Family Medicine Physician 207Q00000X 02007274A IN
Family Medicine Physician 207Q00000X 75137 MN
Family Medicine Physician 207Q00000X 321249 NY
Family Medicine Physician 207Q00000X 81082-21 WI
Family Medicine Physician 207Q00000X 34C.000162 OH
Family Medicine Physician 207Q00000X OS18775 FL Primary

Addresses

Primary practice location

621 W Brandon Blvd
Brandon, FL 33511-5005

Mailing address

621 W Brandon Blvd
Brandon, FL 33511-5005
Phone (813) 681-5702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220722000381 FL Practitioner - Family Practice 0840671848 Reassigns benefits to 6 organizations
I20230808004312 TX Practitioner - Family Practice 0840671848 Reassigns benefits to 1 organization
I20230814002893 IL Practitioner - Family Practice 0840671848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mecnb LLCGroup PAC ID 7911959341, 28 clinicians

Practice addresses (Care Compare)

2720 10TH Ave N
Suite 100
Lake Worth, FL 33461-3100
Phone (561) 540-4446

621 W Brandon Blvd
Wellmed at Brandon Regional
Brandon, FL 33511-5964
Phone (813) 681-5702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010271AZMDFamily Medicine Physician
20A21465CAMDFamily Medicine Physician
UO7323FLMDFamily Medicine Physician
036.163210ILMDFamily Medicine Physician
02007274AINMDFamily Medicine Physician
5101027533MIMDFamily Medicine Physician
75137MNMDFamily Medicine Physician
321249NYMDFamily Medicine Physician
34C.000162OHMDFamily Medicine Physician
81082-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc Family Medicine CurrentSince Aug 7, 2023 Accepting new patients
Cogent Healthcare of Pensacola LLC Family Medicine Current Accepting new patients
Cogent Healthcare of Pensacola LLC CurrentSince Jan 1, 2023 Accepting new patients
Cogent Healthcare of Pensacola LLC CurrentSince Jan 1, 2023 Accepting new patients
Central Florida Inpatient Medicine LLC CurrentSince Mar 1, 2023 Accepting new patients
CTD Network LLC CurrentSince Feb 1, 2023 Accepting new patients
Absolute Health Internal Medicine and Pediatrics CurrentSince May 23, 2022 Accepting new patients

Locations

621 W Brandon Blvd
Brandon, FL 33511
Phone (813) 678-2373

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

1431 SW 1st Ave
Ocala, FL 34471
Phone (352) 401-1425

7350 SW 60th Ave
Ste 2
Ocala, FL 34476
Phone (352) 854-5530

1805 James L Redman Pkwy
#5412
Plant City, FL 33563

1805 James L Redman Pkwy
Ste 201
Plant City, FL 33563
Phone (305) 721-1101

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334

163 Parkhouse St
#1031
Dallas, TX 75207

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eslam.mohamed@wellmed.eclinicaldirectplus.com

Organizations & group practices 8

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 2

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1881220846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115005",
            "telephone_number": "813-681-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115005",
            "telephone_number": "813-681-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "ESLAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-20",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21465",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "UO7323",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U1726",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "010271",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027533",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.163210",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02007274A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "75137",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "321249",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "81082-21",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34C.000162",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS18775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.