Individual provider Active NPI

Ossama Khazaal

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1295117604
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT209817 Issued in PA
Practice address
3401 N Broad St
Temple University Hospital, Suite 226
Philadelphia, PA 19140-5103
Phone
(215) 707-5734
NPI assigned
Jun 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT209817 PA Primary

Addresses

Primary practice location

3401 N Broad St
Temple University Hospital, Suite 226
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Temple University Hospital, Suite 226
Philadelphia, PA 19140-5103
Phone (215) 707-5734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231208000964 NY Practitioner - Neurology 3577912138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1658 Champlin Ave
Utica, NY 13502-4830
Phone (315) 624-6000

Hospital & facility affiliations

  • Wynn Hospital Hospital, Utica, NY, CCN 330044

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT209817PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Nov 20, 2023 Accepting new patients
MVHS Inc CurrentSince Nov 20, 2023 Accepting new patients
MVHS Inc Past Accepting new patients
MVHS Inc Past Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1658 Champlin Ave
Utica, NY 13502

2215 Genesee St
Rm 105
Utica, NY 13501

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: okhazaal42745@mvhealthsystem.direct-ci.com

Organizations & group practices 4

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 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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1295117604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "TEMPLE UNIVERSITY HOSPITAL, SUITE 226",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "TEMPLE UNIVERSITY HOSPITAL, SUITE 226",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZAAL",
        "first_name": "OSSAMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT209817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.