Individual provider Active NPI

Mohammad A Tulimat, M. D.

  • Internal Medicine Physician
  • Independence, KY
National Provider Identifier
1962580258
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42299 Issued in KY
Practice address
2025 Declaration Dr
Independence, KY 41051-7983
Phone
(859) 363-3330
Fax
(859) 359-5478
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301079635 MI
Internal Medicine Physician 207R00000X 35-124503 OH
Internal Medicine Physician 207R00000X 42299 KY Primary

Addresses

Primary practice location

2025 Declaration Dr
Independence, KY 41051-7983

Mailing address

2025 Declaration Dr
Independence, KY 41051-7983
Phone (859) 363-3330

Other identifiers 2

IdentifierTypeStateIssuer
0123044MedicaidOH
7100097830MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20090910000658 KY Practitioner - Family Practice 3678501236 Reassigns benefits to 1 organization
I20141010002245 OH Practitioner - Family Practice 3678501236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
67.04 of 100Reported as individual
Quality
50
Promoting interoperability
0
Improvement activities
40
Cost
90.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42299KYMDInternal Medicine Physician
4301079635MIMDInternal Medicine Physician
35-124503OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenton Housing, Inc. Past Accepting new patients
Shawneespring Health Care Center, LLC Past Accepting new patients
Evan Gray, LLC Past Accepting new patients
Villaspring Health Care Center, LLC Past Accepting new patients
Romeo Urgent Care, PC Internal Medicine Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1962580258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 DECLARATION DR",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517983",
            "telephone_number": "859-363-3330",
            "fax_number": "859-359-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 DECLARATION DR",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517983",
            "telephone_number": "859-363-3330",
            "fax_number": "859-359-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULIMAT",
        "first_name": "MOHAMMAD",
        "middle_name": "A",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301079635",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-124503",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "42299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0123044",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100097830",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KY

Sources for this page

Verify at the official NPI Registry.