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Physician Compare National (NPI:1114134632)

HEALTHCARE PROVIDER: MOHAMMAD MOBAYED MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1114134632
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9739359688
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20200428001308
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MOBAYED
Individual professional last name
Provider First Name MOHAMMAD
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2004
Individual professional's medical school graduation year
Primary Specialty HEMATOLOGY/ONCOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name RENAISSANCE MEDICAL FOUNDATION
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 1153409867
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 73
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 2717 MICHAELANGELO DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 200
Group Practice or individual's line 2 address
City EDINBURG
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 785391412
Group Practice or individual's zip code (9 digits when available)
Phone Number 9563623609
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 230195
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 ST JOHN MACOMB-OAKLAND HOSPITAL-MACOMB CENTER
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 230269
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 BEAUMONT HOSPITAL, TROY
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 450869
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 DOCTORS HOSPITAL AT RENAISSANCE
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 230029
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 ST JOSEPH MERCY OAKLAND
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 230130
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 BEAUMONT HOSPITAL, ROYAL OAK
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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