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DR. OTHMAN MAHMOUD MOHAMMAD MD
NPI 1912138660
Psychiatry & Neurology - Child & Adolescent Psychiatry in Champaign, IL

Active since July 29, 2009PECOS EnrolledAccepts Medicare Assignment
1802 S MATTIS AVE, CHAMPAIGN, IL 61821(217) 365-2855(217) 365-2856 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2026, Mar 9, 2021, Jan 4, 2019 and 2 more (5 updates tracked since 2018).

About Dr. Othman Mahmoud Mohammad Md NPPES

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

DR. OTHMAN MAHMOUD MOHAMMAD MD (NPI 1912138660) is an individual child & adolescent psychiatry provider in Champaign, Illinois, licensed in Illinois (036166927) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1912138660
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. OTHMAN MAHMOUD MOHAMMADCredential: MD
Location Address1802 S MATTIS AVEChampaign, IL 61821-5923
Mailing Address611 W Park StUrbana, IL 61801-2501 · (217) 383-3311
Phone(217) 365-2855
Fax(217) 365-2856
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateJuly 29, 2009
Last NPPES UpdateApril 2, 20265 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1912138660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Licenses✔ Licensed in IL · 036166927✔ Licensed in CT · 066441✔ Licensed in MA · 261296
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 036166927 (IL), 066441 (CT)
1802 S MATTIS AVE, Champaign, IL 61821
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13300 Main St Fl 4Springfield, MA 01107-1112 · Phone (413) 794-5555
Location 242 Wright StreetPalmer, MA 01069-1156 · Phone (413) 370-5285 · Fax (413) 370-5384

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

Dr. Othman Mahmoud Mohammad 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 ID8729301825
PECOS Enrollment IDI20240212000057
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.

Hospital Affiliations CMS Care Compare 4

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Mercy Health Saint Mary's

Acute Care Hospitals · Grand Rapids, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230059
Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Holland Community Hospital

Acute Care Hospitals · Holland, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230072
Location602 Michigan AveHolland, MI 49423 · Ottawa County
Emergency services Birthing friendly

Trinity Health Grand Haven Hospital

Acute Care Hospitals · Grand Haven, MI
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230174
Location1309 Sheldon RdGrand Haven, MI 49417 · Ottawa County
Emergency services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHAEL D RUBIN PHD
Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 255-9580
CARLE CLINIC ASSOCIATION, PC
Durable Medical Equipment & Medical Supplies
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 326-1220
DR. GABRIEL SOTOMAYOR M.D.
Physical Medicine & Rehabilitation
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 902-6954
KRISTINE S ANDERSON PA
Physician Assistant (Surgical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 383-3260
DR. JOHN P BAKER PHD
Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855
SELAHATTIN GOKTURK M.A
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 383-1850
AMANDA GAUGLER
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855
MS. LISA ANNETTE ELLINGWOOD APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855

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 Othman Mohammad's NPI number?

The NPI number for Othman Mohammad is 1912138660. It was assigned to this individual provider in the NPPES registry on July 29, 2009.

Where is Othman Mohammad located?

Othman Mohammad practices at 1802 S Mattis Ave, Champaign, IL 61821. The listed phone number is (217) 365-2855.

What is Othman Mohammad's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Othman Mohammad enrolled in Medicare?

Yes. Othman Mohammad 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.

Is Othman Mohammad affiliated with any hospitals?

According to CMS data, Othman Mohammad is affiliated with Spectrum Health, Mercy Health Saint Mary's, Holland Community Hospital and Trinity Health Grand Haven Hospital.

When was this NPI record last updated?

The NPPES record for Othman Mohammad was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.