Individual provider Active NPI

Haitem Mohamed Muafa

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1649611617
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MT224857 Issued in PA
Practice address
111 S 11TH St Ste 8290
Philadelphia, PA 19107-4824
Phone
(215) 955-2370
NPI assigned
Jul 8, 2013
Last updated
Mar 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 265512 MA
Anesthesiology Physician 207L00000X MT224857 PA Primary

Addresses

Primary practice location

111 S 11TH St Ste 8290
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St Ste 8290
Philadelphia, PA 19107-4824
Phone (215) 955-2370

Other practice location 1

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 937-6439

Other identifiers 1

IdentifierTypeStateIssuer
110114657AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011002169 MA Practitioner - Internal Medicine 1355568981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowell General Inpatient Specialists PLLCGroup PAC ID 8729371380, 70 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 937-6439

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT224857PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Lahey Inpatient Specialists PLLC Internal Medicine CurrentSince Feb 9, 2020 Accepting new patients
Falcon Medical Co LLC Anesthesiology Current Accepting new patients
Lowell General Inpatient Specialists PLLC Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
The Lowell General Hospital Past Accepting new patients
Lowell General Hospital Past Accepting new patients

Locations

290 Littleton Rd
Unit 3
Chelmsford, MA 01824
Phone (978) 258-4734

1 Hospital Dr
Lowell, MA 01852
Phone (978) 687-0156

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

47 High St
Ste 101
North Andover, MA 01845
Phone (978) 258-4734

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

1 Harbison Way
Ste 222
Columbia, SC 29212

Interoperability endpoints

  • Direct secure messaging: hmuafa31688@tuftsmedicine.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

Organizations & group practices 5

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 1

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1649611617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 8290",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 8290",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Varnum Ave",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018542134",
            "country_code": "US",
            "telephone_number": "978-937-6439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUAFA",
        "first_name": "HAITEM",
        "middle_name": "MOHAMED",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "265512",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT224857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110114657A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.