Individual provider Active NPI

Mohammad Al-Mulki, MD

  • Pulmonary Disease Physician
  • East Point, GA
National Provider Identifier
1659330587
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
020396 Issued in GA
Practice address
1136 Cleveland Ave
Ste 519
East Point, GA 30344-3618
Phone
(404) 761-3525
Fax
(404) 766-3696
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 020396 GA Primary
Internal Medicine Physician 207R00000X 020396 GA

Addresses

Primary practice location

1136 Cleveland Ave
Ste 519
East Point, GA 30344-3618

Mailing address

PO Box 91485
East Point, GA 30364-1485
Phone (404) 761-3525

Other identifiers 1

IdentifierTypeStateIssuer
000179286CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210301001977 GA Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5597893685 Practice locations: East Point, GA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1136 Cleveland Ave
Suite 519
East Point, GA 30344-3608
Phone (404) 761-3525

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020396GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1659330587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91485",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303641485",
            "telephone_number": "404-761-3525",
            "fax_number": "404-766-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 CLEVELAND AVE",
            "address_2": "STE 519",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443618",
            "telephone_number": "404-761-3525",
            "fax_number": "404-766-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-MULKI",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "020396",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "020396",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000179286C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

Verify at the official NPI Registry.