Individual provider Active NPI

Mazen Mohandes

  • Student in an Organized Health Care Education/Training Program
  • Dayton, OH
National Provider Identifier
1962342154
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Internal Medicine Clinic, 161 Wyoming Street, Suite 100
Dayton, OH 45409
Phone
(937) 279-8600
NPI assigned
Mar 30, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Internal Medicine Clinic, 161 Wyoming Street, Suite 100
Dayton, OH 45409

Mailing address

Internal Medicine Clinic, 161 Wyoming Street, Suite 100
Dayton, OH 45409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260615003991 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7618449224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1962342154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE CLINIC, 161 WYOMING STREET, SUITE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE CLINIC, 161 WYOMING STREET, SUITE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45409",
            "telephone_number": "937-279-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANDES",
        "first_name": "MAZEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.