Active NPI
Mutaz Al-Nawaflh, MD
- Retina Specialist (Ophthalmology) Physician
- Rockville, MD
National Provider Identifier
1194451211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Retina Specialist (Ophthalmology) Physician
- License
- 24190
- Practice address
- 445 Elmcroft Blvd
Rockville, MD 20850-5667 - Phone
- (202) 468-6664
- NPI assigned
- Jul 29, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Retina Specialist (Ophthalmology) Physician | 207WX0107X | 24190 | ZZ | Primary |
Addresses
Primary practice location
445 Elmcroft Blvd
Rockville, MD 20850-5667
Mailing address
445 Elmcroft Blvd
Rockville, MD 20850-5667
Phone (202) 468-6664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24190 | ZZ | MD | Retina Specialist (Ophthalmology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1194451211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 ELMCROFT BLVD",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505667",
"telephone_number": "202-468-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 ELMCROFT BLVD",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505667",
"telephone_number": "202-468-6664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL-NAWAFLH",
"first_name": "MUTAZ",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-29",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207WX0107X",
"taxonomy_group": "",
"desc": "Ophthalmology, Retina Specialist",
"state": "ZZ",
"license": "24190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.