NPIMap

Individual provider Active NPI

Yaqoob Mohyuddin, MD

  • Cardiovascular Disease Physician
  • Hazleton, PA
National Provider Identifier
1558400010
Registry record updated Mar 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD436604 Issued in PA
Practice address
50 Moisey Drive
Suite 109
Hazleton, PA 18202
Phone
(570) 501-6580
Fax
(570) 501-6598
NPI assigned
Feb 5, 2007
Last updated
Mar 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 044335 CT
Cardiovascular Disease Physician 207RC0000X MD436604 PA Primary

Addresses

Primary practice location

50 Moisey Drive
Suite 109
Hazleton, PA 18202

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20090707000032 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8527166495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Brody School of Medicine at East Carolina University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1250 S Cedar Crest Blvd
300 LVPG Cardiology
Allentown, PA 18103-6381
Phone (610) 402-3110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Dec 20, 2010 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 20, 2010 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2009 Accepting new patients
Hazleton Professional Services CurrentSince Jul 1, 2009 Accepting new patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Johnson Memorial Hospital, Inc. Past Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 300
Allentown, PA 18103
Phone (610) 402-8275

421 Chew St
Allentown, PA 18102
Phone (610) 776-4500

50 Moisey Dr
Ste 103
Hazle Township, PA 18202
Phone (570) 501-1033

50 Moisey Dr
Ste 109
Hazle Township, PA 18202
Phone (570) 501-6460

1000 Alliance Dr
Hazleton, PA 18202
Phone (570) 501-6400

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

Interoperability endpoints

  • Direct secure messaging: ymohyuddin11644@direct2.lvhn.org

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458432000000",
    "number": "1558400010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOISEY DRIVE",
            "address_2": "SUITE 109",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-501-6580",
            "fax_number": "570-501-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHYUDDIN",
        "first_name": "YAQOOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "044335",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD436604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.