NPIMap

Individual provider Active NPI

Mustafa S Mawih, M.D.

  • Nephrology Physician
  • Edgewood, KY
National Provider Identifier
1245641307
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301503360 Issued in MI
Practice address
830 Thomas More Pkwy Ste 200
Edgewood, KY 41017-5103
Phone
(859) 341-6281
Fax
(859) 341-4661
NPI assigned
May 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 4301503360 MI Primary

Addresses

Primary practice location

830 Thomas More Pkwy Ste 200
Edgewood, KY 41017-5103

Mailing address

5333 McAuley Dr
RM 4003
Ypsilanti, MI 48197-1099
Phone (734) 712-3470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20201231000933 MI Practitioner - Internal MedicinePractitioner - Nephrology 9133414097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Michigan PCGroup PAC ID 8729136486, 20 clinicians

Practice addresses (Care Compare)

5333 McAuley Dr
RM 4003
Ypsilanti, MI 48197-1099
Phone (734) 715-1706

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mustafa.mawih.p32@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: mmawih29533@direct.acumenmd.com
  • Direct secure messaging: mustafa.mawih.p2@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: mustafa.mawih.p127@direct.lifelinevascular.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1245641307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "RM 4003",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971099",
            "telephone_number": "734-712-3470",
            "fax_number": "734-712-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 THOMAS MORE PKWY STE 200",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175103",
            "telephone_number": "859-341-6281",
            "fax_number": "859-341-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWIH",
        "first_name": "MUSTAFA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301503360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.