Active NPI
Tala Mohd Eneizat Mahdawi, MD
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1619462728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 736 Cambridge St
Boston, MA 02135-2907 - Phone
- (617) 789-2386
- NPI assigned
- Jun 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
736 Cambridge St
Boston, MA 02135-2907
Mailing address
736 Cambridge St
Boston, MA 02135-2907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
501 45TH St
Munster, IN 46321-5754
Phone (219) 595-5754
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Layous LLC | Current | Accepting new patients | |
| Community Care Network Inc | Past | Accepting new patients |
Locations
501 45th St
Munster, IN 46321
Phone (219) 513-8923
Organizations & group practices 2
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.
-
- Medical Specialty Clinic/Center
- Munster, IN
- NPI 1598144040
-
- Family Medicine Physician
- St John, IN
- NPI 1457610487
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital
- Crown Point, IN
- NPI 1801301437
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Munster, IN
- NPI 1003918210
-
- General Acute Care Hospital
- East Chicago, IN
- NPI 1689776882
-
- General Acute Care Hospital
- Hobart, IN
- NPI 1558463745
-
- General Acute Care Hospital
- Hobart, IN
- NPI 1962504175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530316800000",
"number": "1619462728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021352907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021352907",
"telephone_number": "617-789-2386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENEIZAT MAHDAWI",
"first_name": "TALA",
"middle_name": "MOHD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-30",
"last_updated": "2018-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2018; 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.