Individual provider Active NPI

Mohamed A Abdulla, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Wilkes Barre, PA
National Provider Identifier
1700820487
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD047282L Issued in PA
Practice address
575 N River St
Wilkes Barre, PA 18702-2634
Phone
(570) 552-1435
Fax
(570) 552-1510
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X MD047282L PA
Anatomic Pathology Physician 207ZP0101X 25MA07827100 NJ
Clinical Medical Laboratory 291U00000X 232717-1 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD047282L PA Primary

Addresses

Primary practice location

575 N River St
Wilkes Barre, PA 18702-2634

Mailing address

PO Box 1476
Kingston, PA 18704-0476
Phone (570) 288-8881

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031107000013 PA Practitioner - Pathology 0941113831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyoming Valley Pathology AssociatesGroup PAC ID 3274508965, 5 clinicians

Practice addresses (Care Compare)

575 N River St
Wilkes Barre, PA 18702-2634
Phone (570) 552-1435

Hospital & facility affiliations

  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Merit-based Incentive Payment System (MIPS)

Final score
94.34 of 100Reported as group
Quality
88.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD047282LPAMDAnatomic Pathology & Clinical Pathology Physician
232717-1NYMDClinical Medical Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Valley Pathology Associates CurrentSince Dec 5, 2022 Accepting new patients
St. Luke'S Quakertown Hospital Past Accepting new patients
Wyoming Valley Pathology Associates Clinical Medical Laboratory PastSince Dec 13, 2022 Accepting new patients

Locations

300 Laird St
Ste 2A
Wilkes Barre, PA 18702
Phone (570) 235-1372

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

575 N River St
Wilkes Barre Township, PA 18702
Phone (570) 283-3222

Interoperability endpoints

  • Direct secure messaging: mohamed.abdulla@slpg.direct-sluhn.org

Organizations & group practices 3

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 2

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1700820487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1476",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040476",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022634",
            "telephone_number": "570-552-1435",
            "fax_number": "570-552-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLA",
        "first_name": "MOHAMED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "PA",
            "license": "MD047282L",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NJ",
            "license": "25MA07827100",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "232717-1",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD047282L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.