Individual provider Active NPI

Tasneem Fatima Mohammad

  • Dermatology Physician
  • Detroit, MI
National Provider Identifier
1962820696
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301502259 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2600
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5315064582 MI
Dermatology Physician 207N00000X 4301502259 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200616001608 MI Practitioner - Dermatology 3173748159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

3031 W Grand Blvd
Detroit, MI 48202-3046
Phone (313) 916-2600

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions95
Removal or shaving of skin growth1-10
Skin biopsy23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301502259MIMDDermatology Physician
5315064582MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System Dermatology CurrentSince May 28, 2020 Accepting new patients
Henry Ford Health System CurrentSince May 28, 2020 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

3031 W Grand Blvd
Detroit, MI 48202
Phone (313) 871-3751

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

131 Kercheval Ave
Ste 210B
Grosse Pointe Farms, MI 48236

2825 Livernois Rd
Troy, MI 48083
Phone (248) 680-2060

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

6530 Farmington Rd
Ste 101
West Bloomfield, MI 48322

Interoperability endpoints

  • Direct secure messaging: tasneem.mohammad.1@18430.direct.athenahealth.com
  • Direct secure messaging: tmohammad219214@direct.hfhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1962820696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMAD",
        "first_name": "TASNEEM",
        "middle_name": "FATIMA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5315064582",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301502259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.