Farah Abdul, MD
Individual provider Active NPI Family Medicine Physician · Cheyenne, WY
NPI 1689136202 · NPPES record last updated Jan 9, 2024
Key facts
- NPI
- 1689136202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 229-T1 (WY)
- Practice address
- 820 E 17TH St
Cheyenne, WY 82001-4714 - Phone
- (307) 632-2434
- NPI assigned
- Apr 2, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190821003997 | WA | Order and Referring Only - Family Practice |
1951639442 | |
| I20240819004402 | WY | Order and Referring Only - Family Practice |
1951639442 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 229-T1 | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Health Services | Past | Accepting new patients |
Interoperability endpoints
- farah.abdul.1@30244.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 229-T1 | WY | Yes |
Addresses
Primary practice location
820 E 17TH St
Cheyenne, WY 82001-4714
Mailing address
820 E 17TH St
Cheyenne, WY 82001-4714
Phone (307) 632-2434
Other providers in Cheyenne, WY
- A Step Ahead Foot and Ankle Center LLC
- A. E. Roedel Drug Inc
- ABA Skill Builders Wy LLC
- Abdel DME Corp
- Bilal Abdul Haqq
- Saralena Abeyta
- Abilities Unlimited of Cheyenne
- Absolute Respiratory Care
- Abundantly Fruitful
- Access Health Care - LLC
All providers in Cheyenne, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.