Mohamad Talal Basrak

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MT230445 Issued in PA

Practice address

140 Nutt Rd
Phoenixville, PA 19460-3906

Phone

(484) 921-7650

NPI assigned

Jul 11, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1700623386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 WESTRIDGE GARDENS WAY",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194603368",
            "telephone_number": "484-921-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NUTT RD",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194603906",
            "telephone_number": "484-921-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASRAK",
        "first_name": "MOHAMAD TALAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT230445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Baker, LCSW
• Cecelia Saunders Baldwin, B.A
• Samantha Baro, CRNP
• Julie Barrett
• Andrew Baskin, M.D.
• Victoria Batten, BS
• Burke Beauregard, MD
• Meghan Beck
• Alyson Becker, M.S. CCC-SLP
• Ryan Andrew Becker, D.M.D., M.S.

• Internal Medicine Physician in Phoenixville, PA
• Providers in Phoenixville, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.