Individual provider Active NPI

Ayesha Moghul

  • Internal Medicine Physician
  • Danville, PA
National Provider Identifier
1215390133
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0024241 Issued in DE
Practice address
Geisinger Medical Ctr
100 North Academy Avenue
Danville, PA 17822-0001
Phone
(570) 271-6211
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 C1-0024241 DE Primary
Internal Medicine Physician 207R00000X 283809 MA

Addresses

Primary practice location

Geisinger Medical Ctr
100 North Academy Avenue
Danville, PA 17822-0001

Mailing address

44 Cherry Street
Unit B
Danville, PA 17821-0001
Phone (510) 825-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201119000152 MA Practitioner - Internal Medicine 5597046326 Reassigns benefits to 3 organizations
I20210608002582 DE Practitioner - Internal Medicine 5597046326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pittsburgh School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 623-0188

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 31, 2020 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jun 1, 2021 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 31, 2020 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Internal Medicine CurrentSince Aug 31, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine CurrentSince Aug 31, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 31, 2020 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Aug 31, 2020 Accepting new patients
Christiana Care Health Services, Inc. Past Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

Organizations & group practices 9

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 1

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1215390133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CHERRY STREET",
            "address_2": "UNIT B",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178210001",
            "telephone_number": "510-825-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GEISINGER MEDICAL CTR",
            "address_2": "100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHUL",
        "first_name": "AYESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0024241",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "283809",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.