NPIMap

Individual provider Active NPI

Ammar Mushtaq, MD

  • Internal Medicine Physician
  • Roswell, NM
National Provider Identifier
1902459704
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2022-1467 Issued in NM
Practice address
400 Military Heights PL
Roswell, NM 88201-6407
Phone
(575) 627-9500
Fax
(575) 627-9535
NPI assigned
Jul 20, 2019
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125074267 IL
Internal Medicine Physician 207R00000X MD2022-1467 NM Primary

Addresses

Primary practice location

400 Military Heights PL
Roswell, NM 88201-6407

Mailing address

355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-6228

Other practice location 1

355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-6228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20230105002573 NM Practitioner - Internal Medicine 3577933639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Masoud Khorsand- Sahbaie MD P aGroup PAC ID 8729068911, 19 clinicians

Practice addresses (Care Compare)

400 Military Heights PL
Roswell, NM 88201-6407
Phone (575) 627-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2022-1467NMMDInternal Medicine Physician
125074267ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Masoud Khorsand-Sahbaie, MD PA Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Masoud Khorsand- Sahbaie MD P a CurrentSince Jan 1, 2023 Accepting new patients

Locations

101 S Canal St
Carlsbad, NM 88220
Phone (575) 234-0500

3028 N Grimes St
Hobbs, NM 88240
Phone (575) 392-0222

400 Military Heights Pl
Roswell, NM 88201
Phone (575) 627-9110

407 W Country Club Rd
Roswell, NM 88201
Phone (505) 627-9110

Interoperability endpoints

  • Direct secure messaging: ammar.mushtaq.p1@direct.kymeramedical.nextgenshare.com

Organizations & group practices 2

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 7

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": "1563580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1902459704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "847-316-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MILITARY HEIGHTS PL",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016407",
            "telephone_number": "575-627-9500",
            "fax_number": "575-627-9535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602023328",
            "country_code": "US",
            "telephone_number": "847-316-6228",
            "fax_number": "847-316-3307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSHTAQ",
        "first_name": "AMMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-20",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125074267",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2022-1467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.