Mohammed Shujauddin Ahmed, D.O.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036113939 Issued in IL

Practice address

396 Remington Blvd Ste 140
Bolingbrook, IL 60440-4311

Phone

(630) 495-9356

Fax

(630) 495-9357

NPI assigned

Oct 31, 2006

Last updated

Oct 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nephrology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nephrology Associates of Northern Illinois LTDGroup PAC ID 2163328675, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usrc Bolingbrook Dialysis facility, Bolingbrook, IL, CCN 142749
• FMC - Bolingbrook Dialysis Dialysis facility, Bolingbrook, IL, CCN 142605
• Uchicago Medicine Adventhealth Bolingbrook Hospital, Bolingbrook, IL, CCN 140304
• Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
• Edward Hospital Hospital, Naperville, IL, CCN 140231

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: mahmed49680@direct.acumenmd.com

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.

• Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1124069182
  Medicare reassignment Care Compare group NPD
• Nani Elk Grove

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1154675528
  Medicare reassignment NPD
• Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1134319924
  NPD
• Adventist Health Partners, Inc

  dba Hinsdale Primary Care

  • Family Medicine Physician
  • Hinsdale, IL
  • NPI 1952339939
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Usrc Bolingbrook LLC

  dba U.S. Renal Care Bolingbrook Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bolingbrook, IL
  • NPI 1497015390

  Dialysis facility

  Care Compare affiliation Name & address match
• WSKC Dialysis Services, Inc.

  dba Fresenius Medical Care Bolingbrook

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bolingbrook, IL
  • NPI 1588779326

  Dialysis facility

  Care Compare affiliation Name & address match
• Adventist Bolingbrook Hospital

  dba Adventhealth Bolingbrook

  • General Acute Care Hospital
  • Bolingbrook, IL
  • NPI 1164530465
  Care Compare affiliation
• Adventist Midwest Health

  • General Acute Care Hospital
  • Hinsdale, IL
  • NPI 1265465439
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth Hinsdale

  • Psychiatric Hospital Unit
  • Hinsdale, IL
  • NPI 1447270780
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate Good Samaritan Hospital

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  Care Compare affiliation
• Edward Hospital

  dba Endeavor Health Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1962588061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-575-5000",
            "fax_number": "630-491-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD STE 140",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404311",
            "telephone_number": "630-495-9356",
            "fax_number": "630-495-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MOHAMMED",
        "middle_name": "SHUJAUDDIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-113939",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036113939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036113939",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "400280",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Agape Home Health of Illinois, Inc.
• Agape Solutions Inc (DuPage Will Family Caring Angels)
• Gifty Agyemang
• Saira Manahil Ahmad, CNA
• Irma Ahmed, MD
• Air Angels, Inc.
• Manju M Akhand, M.D.
• Naveed Akhtar, M.D.
• Youssef E Akl, MD
• Ghiath Al Kassar, M.D

• Nephrology Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.

Verify at the official NPI Registry.