Individual provider Active NPI

Samah Abdallah, MD

  • Internal Medicine Physician
  • Brighton, MA
National Provider Identifier
1730814971
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
293965 Issued in MA
Practice address
736 Cambridge St
Brighton, MA 02135-2907
Phone
(617) 779-6342
NPI assigned
Jul 21, 2022
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 293965 MA Primary

Addresses

Primary practice location

736 Cambridge St
Brighton, MA 02135-2907

Mailing address

1568 Commonwealth Ave Apt 11
Brighton, MA 02135-5009
Phone (315) 450-5687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250604002532 MI Order and Referring Only - Pulmonary DiseasePractitioner - Pulmonary Disease 9537603030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
293965MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730814971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 COMMONWEALTH AVE APT 11",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021355009",
            "telephone_number": "315-450-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-779-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "SAMAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "293965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.