NPIMap

Individual provider Active NPI

Mona Al Mukaddam, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Philadelphia, PA
National Provider Identifier
1043400567
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD445313 Issued in PA
Practice address
3400 Civic Center Blvd.
West Pavilion, 4TH Floor
Philadelphia, PA 19104-5134
Phone
(215) 662-2300
Fax
(215) 614-0418
NPI assigned
Jul 31, 2007
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD445313 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD445313 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd.
West Pavilion, 4TH Floor
Philadelphia, PA 19104-5134

Mailing address

3400 Civic Center Blvd.
West Pavilion, 4TH Floor
Philadelphia, PA 19104-5134
Phone (215) 662-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120618000152 PA Practitioner - EndocrinologyPractitioner - Internal Medicine 4183888431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2300

3600 Civic Ctr Blvd
Philadelphia, PA 19104

3737 Market St
Philadelphia, PA 19104-5545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD445313PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
University of Penn - Medical Group Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2012 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3737 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 662-2775

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1043400567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "WEST PAVILION, 4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045134",
            "telephone_number": "215-662-2300",
            "fax_number": "215-614-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "WEST PAVILION, 4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045134",
            "telephone_number": "215-662-2300",
            "fax_number": "215-614-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL MUKADDAM",
        "first_name": "MONA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD445313",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD445313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.