DR. MOHAMMAD BASIL AMIN (M.D) – Internal Medicine Physician, NPI 1104881101
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. MOHAMMAD BASIL AMIN (M.D)
205, Zeagler Drive, Palatka, Putnam County, Florida, 32177, United States
SUITE # 401-B
PALATKA, FL 32177
Phone: (386) 325-8482
Fax: (386) 325-3512
Type: Location
East Palatka Post Office, E. McCormick Rd., East Palatka, Putnam County, Florida, 32131, United States
PALATKA, FL 32177
Phone: (386) 325-8482
Fax: (386) 325-3512
Type: Mailing
142 WOODRIDGE RD
BERLIN, VT 056029165
Phone: (802) 371-4700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-12-26
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 |
|---|---|---|---|---|
| I20220825003657 | I | Internal Medicine | NY | TBD |
| I20241226002024 | I | Internal Medicine | VT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32177)
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