MOHAMMAD TABATABAEI (P.A.-C) – Physician Assistant, NPI 1215954813
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MOHAMMAD TABATABAEI (P.A.-C)
1220 W JACKSON ST
SULLIVAN, IL 619511032
Phone: (217) 728-2042
Fax: (217) 728-2485
Type: Location
Decatur Memorial Hospital, 2300, North Edward Street, Old King's Orchard, Decatur, Macon County, Illinois, 62526, United States
GSBLL
DECATUR, IL 625264163
Phone: (217) 876-2857
Fax: (217) 876-2874
Type: Mailing
3131, North Water Street, Decatur, Macon County, Illinois, 62526, United States
DECATUR, IL 625262472
Phone: (217) 876-5320
Fax: (217) 876-5865
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $35.
Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.
Last reported payment date: 2023-11-07 • Largest payer in this snapshot: Lilly USA, LLC ($20).
Total Amount
$35
General + Research + Ownership
Payments
2
Total payment records
General Amount
$35
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $20 |
| GlaxoSmithKline, LLC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-12-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041206001120 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 608 | 351 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 272 | 207 | $0 |
| 93793 | Anticoagulant management of patient taking warfarin | 84 | 18 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 16 | 16 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 61951)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| General Surgery, Colorectal Surgery (Proctology) | IL | |
| Cardiovascular Disease (Cardiology), Internal Medicine, Interventional Cardiology | MO | |
| Nurse Practitioner | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | IL | |
| - | IL | |
| - | IL | |
| - | IL |
Reviews
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