Individual provider Active NPI

Zakiyyah Muhsin-Fall

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1720612914
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP029369 Issued in PA
Practice address
499 N 5TH St Ste a
Philadelphia, PA 19123-4005
Phone
(215) 451-7000
NPI assigned
Feb 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X SPO21531 PA
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X SP029369 PA Primary

Addresses

Primary practice location

499 N 5TH St Ste a
Philadelphia, PA 19123-4005

Mailing address

499 N 5TH St Ste a
Philadelphia, PA 19123-4005
Phone (215) 451-7000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511001671 PA Practitioner - Nurse Practitioner 0941619589 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forge Medical Group, LLCGroup PAC ID 5597163949, 35 clinicians

Practice addresses (Care Compare)

40 Huff Ave Ext
Greensburg, PA 15601-5484
Phone (724) 836-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SPO21531PAMDFamily Nurse Practitioner
SP029369PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meditelecare of Pennsylvania LLC Multi-Specialty CurrentSince Sep 14, 2022 Accepting new patients
Forge Medical Group, LLC Multi-Specialty CurrentSince Jan 1, 2025 Accepting new patients
Psychogeriatric Services LLC Multi-Specialty CurrentSince May 3, 2021 Accepting new patients
Betteru Wellness and Psychiatric Services PLLC Multi-Specialty CurrentSince Mar 11, 2025 Accepting new patients
Forge Medical Group, LLC Multi-Specialty CurrentSince Jan 1, 2025 Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

10 Bank St
Ste 830
White Plains, NY 10606
Phone (888) 224-7312

595 Biglerville Rd
Gettysburg, PA 17325
Phone (717) 334-6249

40 Huff Avenue Ext
Greensburg, PA 15601
Phone (724) 836-3960

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

150 S Warner Rd
Ste 110
King of Prussia, PA 19406

150 S Warner Rd
King of Prussia, PA 19406
Phone (484) 401-7621

146 E King St
Lancaster, PA 17602
Phone (302) 990-2323

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1720612914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 N 5TH ST STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234005",
            "telephone_number": "215-451-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 N 5TH ST STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234005",
            "telephone_number": "215-451-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHSIN-FALL",
        "first_name": "ZAKIYYAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2025-02-08",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SPO21531",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP029369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.