Active NPI
Mohammad A Tulimat, M. D.
- Internal Medicine Physician
- Independence, KY
National Provider Identifier
1962580258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 42299
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0123044 | Medicaid | OH | |
| 7100097830 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 67.04 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 42299 | KY | MD | Internal Medicine Physician |
| 4301079635 | MI | MD | Internal Medicine Physician |
| 35-124503 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Skilled Nursing Facility
- Florence, KY
- NPI 1326020348
-
- Nursing Facility/Intermediate Care Facility
- Covington, KY
- NPI 1720077704
-
- Skilled Nursing Facility
- Erlanger, KY
- NPI 1942208103
-
- Skilled Nursing Facility
- Harrison, OH
- NPI 1346219987
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.