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MOHAMMED K QAISI DMD, MD
NPI 1679783088
Oral & Maxillofacial Surgery in Chicago, IL

Active since May 23, 2007PECOS EnrolledAccepts Medicare Assignment
1969 W OGDEN AVE # CLINICD, CHICAGO, IL 60612(128) 645-1633 Get Directions Write a Review

NPPES record last updated: April 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 28, 2021, Jul 23, 2019 (2 updates tracked since 2019).

About Mohammed K Qaisi Dmd, Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAMMED K QAISI DMD, MD (NPI 1679783088) is an individual oral & maxillofacial surgery provider in Chicago, Illinois, licensed in Illinois (036.139464) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Advocate Sherman Hospital, and maintains a secondary practice location in Jackson.

NPPES Registry Identity

NPI1679783088
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameMOHAMMED K QAISICredential: DMD, MD
Location Address1969 W OGDEN AVE # CLINICDChicago, IL 60612-3765
Mailing Address1969 W Ogden AveChicago, IL 60612-3765 · (128) 645-1633
Phone(128) 645-1633
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2008
Enumeration DateMay 23, 2007
Last NPPES UpdateApril 28, 20212 updates tracked since enumeration
NPPES CertifiedApril 28, 2021
✔ NPI 1679783088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in IL · 036.139464
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 019.030516 (IL)
1969 W OGDEN AVE # CLINICD, Chicago, IL 60612
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Secondary Practice Location 1

Location 12500 N State St, University of Mississippi Medical CenterJackson, MS 39216-4500 · Phone (601) 815-1181 · Fax (601) 815-5306

Other Identifiers 1

Medicaid21459LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mohammed K Qaisi Dmd, Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820212038
PECOS Enrollment IDI20160314001703
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
113 services49 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Sherman Hospital

Acute Care Hospitals · Elgin, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140030
Location1425 North Randall RoadElgin, IL 60123 · Kane County
Emergency services Birthing friendly

Advocate Trinity Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140048
Location2320 E 93rd StChicago, IL 60617 · Cook County
Emergency services Birthing friendly

Advocate Illinois Masonic Medical Center

Acute Care Hospitals · Chicago, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140182
Location836 West Wellington AvenueChicago, IL 60657 · Cook County
Emergency services Birthing friendly

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Advocate Good Samaritan Hospital

Acute Care Hospitals · Downers Grove, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140288
Location3815 Highland AvenueDowners Grove, IL 60515 · Du Page County
Emergency services Birthing friendly

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mohammed Qaisi's NPI number?

The NPI number for Mohammed Qaisi is 1679783088. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is Mohammed Qaisi located?

Mohammed Qaisi practices at 1969 W Ogden Ave # Clinicd, Chicago, IL 60612. The listed phone number is (128) 645-1633.

What is Mohammed Qaisi's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Mohammed Qaisi enrolled in Medicare?

Yes. Mohammed Qaisi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mohammed Qaisi accept?

Health plans from Humana list Mohammed Qaisi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mohammed Qaisi affiliated with any hospitals?

According to CMS data, Mohammed Qaisi is affiliated with Advocate Sherman Hospital, Advocate Trinity Hospital, Advocate Illinois Masonic Medical Center, Advocate Christ Hospital & Medical Center and Advocate Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Mohammed Qaisi was last updated on April 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.