Mohammad Abushanab, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA12299700 Issued in NJ

Practice address

111 Central Ave Dept Floord7
Newark, NJ 07102-1909

Phone

(973) 877-5487

NPI assigned

Jul 20, 2021

Last updated

Jul 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Avenue Professional Services, PCGroup PAC ID 7214258003, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Michael's Medical Center Hospital, Newark, NJ, CCN 310096

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Central Avenue Professional Services, PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Newark, NJ
  • NPI 1447649694
  Medicare reassignment Care Compare group NPD
• Prime Healthcare Services - St Michaels LLC

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1568825545
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - St Michaels LLC

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1568825545
  Care Compare affiliation

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1265005953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE DEPT FLOORD7",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE DEPT FLOORD7",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUSHANAB",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12299700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "newark",
            "affiliation": "N",
            "address_1": "111 Central Ave Dept Floord7",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071021909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amany Abu Hanoud, M.D
• Yazeed Fawwaz Abu Ruman, M.B.B.S
• Ahmed Abu Taleb, M.D
• Nancy Leroux Abud, M.D.
• Abundant Hope Developmental Supports NJ LLC
• Odai Abushanab, DMD
• Islam K Abusido, M.D.
• Access Medicine NJ
• Luis Acevedo
• Sashali Acevedo

• Internal Medicine Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.