NPIMap

Individual provider Active NPI

Mohieddin Kebab

  • Family Medicine Physician
  • Clarion, PA
National Provider Identifier
1912520792
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57502 Issued in KY
Practice address
24 Doctors LN Ste 202
Clarion, PA 16214-8574
Phone
(814) 226-2500
Fax
(814) 226-2501
NPI assigned
May 27, 2020
Last updated
May 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.148866 OH
Family Medicine Physician 207Q00000X 57502 KY Primary
Family Medicine Physician 207Q00000X MT220599 PA

Addresses

Primary practice location

24 Doctors LN Ste 202
Clarion, PA 16214-8574

Mailing address

121 Doctors LN
Clarion, PA 16214-8515
Phone (814) 226-3494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230113001082 KY Practitioner - Family Practice 0547631368 Reassigns benefits to 1 organization
I20230911003133 OH Practitioner - Family Practice 0547631368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Ohio LLCGroup PAC ID 9032527221, 232 clinicians
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Springfield, OH 45504-2687
Phone (937) 523-1461

3300 Mercy Health Blvd
Cincinnati, OH 45211-1103
Phone (513) 215-5000

650 Sprucewood LN
Erlanger, KY 41018-1062
Phone (859) 282-6600

7300 Beechmont Ave
Cincinnati, OH 45230-4119
Phone (513) 232-9100

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.148866OHMDFamily Medicine Physician
MT220599PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Ohio, LLC CurrentSince Jun 19, 2024 Accepting new patients
Doctors Urgent Care Offices Medical Group Inc CurrentSince Dec 16, 2022 Accepting new patients
CG Medical Associates Inc Family Medicine CurrentSince Dec 16, 2022 Accepting new patients
Mercy Health - West Hospital LLC Past Accepting new patients

Locations

650 Sprucewood Ln
Erlanger, KY 41018
Phone (859) 282-6600

7683 Mall Rd
Unit B
Florence, KY 41042
Phone (859) 817-1320

3457 Valleyplaza Pkwy
Ft Wright, KY 41017
Phone (513) 846-6778

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

Organizations & group practices 4

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 5

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": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1912520792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DOCTORS LN",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148515",
            "telephone_number": "814-226-3494",
            "fax_number": "814-226-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 DOCTORS LN STE 202",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148574",
            "telephone_number": "814-226-2500",
            "fax_number": "814-226-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBAB",
        "first_name": "MOHIEDDIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.148866",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "57502",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT220599",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarion, PA

Sources for this page

Verify at the official NPI Registry.