NPIMap

Individual provider Active NPI

Mohamad H Taha, MD

  • Cardiovascular Disease Physician
  • Harrisburg, PA
National Provider Identifier
1629488473
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD463765 Issued in PA
Practice address
4300 Londonderry Rd
Harrisburg, PA 17109
Phone
(717) 231-8772
Fax
(717) 231-8435
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 60117 CT
Internal Medicine Physician 207R00000X MD463765 PA
Cardiovascular Disease Physician 207RC0000X MD463765 PA Primary

Addresses

Primary practice location

4300 Londonderry Rd
Harrisburg, PA 17109

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Other practice location 1

205 S Front St
Department of Internal Medicine
Harrisburg, PA 17104-1619
Phone (717) 231-8506

Other practice location 2

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7000

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
I20180605000988 PA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Hospitalist 4284852575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMC Specialty Physicians LLCGroup PAC ID 2466680566, 12 clinicians

Practice addresses (Care Compare)

2705 Dekalb Pike
Suite 202
East Norriton, PA 19401-1852
Phone (610) 275-7240

501 Bath Rd
Bristol, PA 19007-3101

5735 Ridge Ave
Philadelphia, PA 19128-1746
Phone (215) 487-1887

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting23
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)11
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BMC Specialty Physicians LLC Cardiovascular Disease CurrentSince Jun 1, 2021 Accepting new patients
Suburban Medical Group LLC Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

501 Bath Rd
Bristol, PA 19007
Phone (215) 785-9200

501 Bath Rd
Ste 208
Bristol, PA 19007
Phone (215) 739-2121

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

2705 DeKalb Pike
Ste 203
Norristown, PA 19401
Phone (610) 275-1028

5735 Ridge Ave
Ste 106
Philadelphia, PA 19128
Phone (215) 482-2412

5800 Ridge Ave
Philadelphia, PA 19128
Phone (215) 487-4334

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.

Hospital & facility affiliations 12

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1629488473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17109",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 S Front St",
            "address_2": "Department of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171041619",
            "country_code": "US",
            "telephone_number": "717-231-8506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106099",
            "country_code": "US",
            "telephone_number": "203-739-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAHA",
        "first_name": "MOHAMAD",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "60117",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD463765",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD463765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.