Diane Al-Abduljalil, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

32462 Issued in CO

Practice address

4105 Crocus LN
Colorado Springs, CO 80918-4413

Phone

(719) 264-6271

Fax

(719) 264-6298

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

Yes

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.

• Bupdoc LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Colorado Springs, CO
  • NPI 1679059687
  NPD
• Memorial Health System

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1568668754
  NPD (past)
• Trinidad Area Health Association

  • Family Medicine Physician
  • Trinidad, CO
  • NPI 1467400309
  NPD (past)
• Uch-MHS

  • Ambulance
  • Colorado Springs, CO
  • NPI 1417512559
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346458221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 CROCUS LANE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184413",
            "telephone_number": "719-264-6271",
            "fax_number": "719-264-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 CROCUS LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184413",
            "telephone_number": "719-264-6271",
            "fax_number": "719-264-6298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-ABDULJALIL",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "32462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01324623",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akvc North LLC
• Akvc North LLC
• Adora Akwuba, FNP-BC
• Dana Al Khatib, DDS
• Lubna Al Sindy
• Saja Al-Falahi
• Patricia Caroline Al-Nasser, PHARMD
• Nasser Obaid Al-Shamesi, LPCC
• Bethany Lea Alabi, LCSW
• Mehwish Alam

• All providers in Colorado Springs, CO
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.