Individual provider Active NPI

Mohammad Abdul Motalib, MD

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1740217157
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207P00000X Issued in KY
Practice address
830 S Limestone Street
Lexington, KY 40536-2389
Phone
(859) 218-3206
NPI assigned
Jun 28, 2006
Last updated
May 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2018

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 207P00000X KY Primary

Addresses

Primary practice location

830 S Limestone Street
Lexington, KY 40536-2389

Mailing address

830 South Limestone Street
Lexington, KY 40536-0001
Phone (859) 218-3206

Other practice location 1

830 South Limestone Street
Lexington, KY 40536-2389
Phone (859) 218-3206

Other identifiers 1

IdentifierTypeStateIssuer
64332240MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207P00000XKYMDPersonal Emergency Response Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Lung & Sleep Specialists, PSC. Past Accepting new patients
Jackson Hospital Corporation Past Accepting new patients
Owen Emergency Physicians Past Accepting new patients
Diagnostic Sleep Center Past Accepting new patients
Jackson Physician Corp Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmotalib55548@ukhcdirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1740217157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SOUTH LIMESTONE STREET",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-218-3206",
            "fax_number": "859-257-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S LIMESTONE STREET",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405362389",
            "telephone_number": "859-218-3206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 South Limestone Street",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405362389",
            "country_code": "US",
            "telephone_number": "859-218-3206",
            "fax_number": "859-257-2625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTALIB",
        "first_name": "MOHAMMAD",
        "middle_name": "ABDUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "207P00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64332240",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.