Individual provider Active NPI

Abdullah Hanna-Moussa, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Peoria, AZ
National Provider Identifier
1194735456
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
41644 Issued in AZ
Practice address
7972 W Thunderbird Rd Ste 104
Peoria, AZ 85381-4903
Phone
(623) 249-7551
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 41644 AZ Primary

Addresses

Primary practice location

7972 W Thunderbird Rd Ste 104
Peoria, AZ 85381-4903

Mailing address

7972 W Thunderbird Rd Ste 104
Peoria, AZ 85381-4903
Phone (623) 249-7551

Other identifiers 1

IdentifierTypeStateIssuer
451541MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090911000313 AZ Practitioner - Endocrinology 9032106406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7972 W Thunderbird Rd
Suite 104
Peoria, AZ 85381-4903
Phone (623) 249-7551

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41644AZMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Endocrinology & Diabetes Clinic Inc Endocrinology, Diabetes & Metabolism CurrentSince Jan 21, 2018 Accepting new patients

Locations

18301 N 79th Ave
Ste C136
Glendale, AZ 85308
Phone (623) 500-6207

7972 W Thunderbird Rd
Ste 104
Peoria, AZ 85381
Phone (480) 360-4263

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GICDBD/Endpoint/GICDBD

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1194735456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7972 W THUNDERBIRD RD STE 104",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814903",
            "telephone_number": "623-249-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7972 W THUNDERBIRD RD STE 104",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814903",
            "telephone_number": "623-249-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA-MOUSSA",
        "first_name": "ABDULLAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AZ",
            "license": "41644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451541",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.