Individual provider Active NPI

Maha Abdulla, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Beverly, MA
National Provider Identifier
1740662469
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
1017579 Issued in MA
Practice address
85 Herrick St
Beverly, MA 01915-1790
Phone
(978) 922-3000
NPI assigned
Jun 18, 2015
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20A15951 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 1017579 MA Primary

Addresses

Primary practice location

85 Herrick St
Beverly, MA 01915-1790

Mailing address

41 Mall Rd
Burlington, MA 01805-0001

Other practice location 1

1800 N California St
Stockton, CA 95204-6019
Phone (209) 943-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230713000948 IL Practitioner - Pathology 2365738812 Reassigns benefits to 2 organizations
I20231211003055 MA Practitioner - Pathology 2365738812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15951CAMDAnatomic Pathology & Clinical Pathology Physician
1017579MAMDAnatomic Pathology & Clinical Pathology Physician
15951CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Current Accepting new patients
SSM Health Care Group Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 2024 Accepting new patients
City of Hope Medical Group of Illinois PLLC CurrentSince Jul 3, 2023 Accepting new patients
SSM Health Care Group CurrentSince Oct 1, 2024 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Organizations & group practices 4

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1740662469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-922-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 N California St",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952046019",
            "country_code": "US",
            "telephone_number": "209-943-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDULLA",
        "first_name": "MAHA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "20A15951",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "1017579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.