MOHAMMED K QAISI (DMD, MD) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1679783088
Oral & Maxillofacial Surgery (D.M.D.)
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Profile Insights
NPPES metrics only — not quality of care.
56 ORAL SURGERY in IL
Provider Addresses for MOHAMMED K QAISI (DMD, MD)
1969 W OGDEN AVE # CLINICD
CHICAGO, IL 606123765
Phone: (128) 645-1633
Type: Location
John H. Stroger, Jr. Hospital of Cook County, 1969, West Ogden Avenue, Near West Side, Illinois Medical District, Chicago, Illinois Medical District, Illinois, 60612, United States
CHICAGO, IL 606123765
Phone: (128) 645-1633
Type: Mailing
2500 N State St
University of Mississippi Medical Center
Jackson, MS 392164500
Phone: (601) 815-1181
Fax: (601) 815-5306
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $1,000.
Total Amount is formed as General ($1,000) + Research ($0) + Ownership ($0) = $1,000.
Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Keystone Dental Inc. ($700).
Total Amount
$1,000
General + Research + Ownership
Payments
14
Total payment records
General Amount
$1,000
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-11
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2016-03-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20140609002334 | I | Oral Surgery | MS | TBD |
| I20160314001703 | I | Oral Surgery | 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 | 42 | 27 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 41 | 41 | $0 |
Insurance plans in this area (ZIP 60612)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery, Maxillofacial Surgery | IL | |
| O T O L A R Y N G O L O G Y | IL |
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