Individual provider Active NPI

Muhammad K. Al Mounayer, M.D.

  • Internal Medicine Physician
  • Wallingford, CT
National Provider Identifier
1093717837
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015-1230 Issued in NC
Practice address
Gaylord Hospital
Gaylord Farm Rd.
Wallingford, CT 06492
Phone
(203) 284-2800
Fax
(203) 679-3598
NPI assigned
Aug 11, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 043096 CT
Internal Medicine Physician 207R00000X 2015-1230 NC Primary

Addresses

Primary practice location

Gaylord Hospital
Gaylord Farm Rd.
Wallingford, CT 06492

Mailing address

2900 Main St
Apt. #201
Bridgeport, CT 06606-4236
Phone (203) 368-6950

Other practice location 1

800 N Justice St
Hendersonville, NC 28791-3410
Phone (828) 696-1000

Other identifiers 1

IdentifierTypeStateIssuer
NCQ268OtherNCMEDICARE ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151120000734 NC Practitioner - HospitalistPractitioner - Internal Medicine 0547204174 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043096CTMDInternal Medicine Physician
2015-1230NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince May 1, 2017 Accepting new patients
Henderson County Hospital Corporation CurrentSince May 1, 2017 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Saint Raphael Faculty Physicians Internal Medicine Past Accepting new patients

Locations

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093717837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 MAIN ST",
            "address_2": "APT. #201",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064236",
            "telephone_number": "203-368-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GAYLORD HOSPITAL",
            "address_2": "GAYLORD FARM RD.",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-2800",
            "fax_number": "203-679-3598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N Justice St",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "287913410",
            "country_code": "US",
            "telephone_number": "828-696-1000",
            "fax_number": "828-696-1314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL MOUNAYER",
        "first_name": "MUHAMMAD",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "043096",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-1230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "NCQ268",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.