NPIMap

Individual provider Active NPI

Mohammed Muttahhar Mohiuddin, M.D.

  • Surgical Critical Care Physician
  • Hagerstown, MD
National Provider Identifier
1336702406
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
D0104273 Issued in MD
Practice address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone
(301) 790-8380
NPI assigned
Apr 15, 2019
Last updated
Jul 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Surgical Critical Care Physician 2086S0102X MD486756 PA
Surgical Critical Care Physician 2086S0102X D0104273 MD Primary

Addresses

Primary practice location

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8380

Other practice location 1

2100 SE Blue Pkwy
Lees Summit, MO 64063-1007
Phone (816) 282-5000

Other practice location 2

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-2200

Other practice location 3

500 Plaza Ct
East Stroudsburg, PA 18301-8262
Phone (570) 426-2301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250423001152 PA Practitioner - General Surgery 1456876382 Reassigns benefits to 1 organization
I20251018000026 MD Practitioner - General Surgery 1456876382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians

Practice addresses (Care Compare)

1021 Park Ave
Quakertown, PA 18951-0130

11110 Medical Campus Rd
Suite 143
Hagerstown, MD 21742-6755
Phone (301) 704-4350

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8000

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (484) 526-7800

700 Lawn Ave
Sellersville, PA 18960-1548
Phone (484) 822-5700

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD486756PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritus Medical Center Inc CurrentSince Oct 1, 2025 Accepting new patients
Meritus Medical Center Inc Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 12, 2025 Accepting new patients
Meritus Medical Center Inc CurrentSince Oct 1, 2025 Accepting new patients
Lehigh Valley Physician Group Surgery Current Accepting new patients
Medical Practices of Antietam, LLC CurrentSince Oct 1, 2025 Accepting new patients
Medical Practices of Antietam LLC CurrentSince Oct 1, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 12, 2025 Accepting new patients

Locations

11110 Medical Campus Rd
Ste 143
Hagerstown, MD 21742
Phone (301) 714-4175

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150

2100 Mack Blvd
Fl 4
Allentown, PA 18103

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

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 8

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1336702406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 SE Blue Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640631007",
            "country_code": "US",
            "telephone_number": "816-282-5000",
            "fax_number": "913-498-6708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151000",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "484-526-6459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Plaza Ct",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183018262",
            "country_code": "US",
            "telephone_number": "570-426-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHIUDDIN",
        "first_name": "MOHAMMED",
        "middle_name": "MUTTAHHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD486756",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MD",
            "license": "D0104273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.