NPIMap

Individual provider Active NPI

Muhammad L. Robbalaa

  • Counselor
  • Chester, PA
National Provider Identifier
1750935987
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1120 W 3Rd St # a
Chester, PA 19013-3622
Phone
(215) 435-4203
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X OK
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X OK
Counselor 101Y00000X OK Primary

Addresses

Primary practice location

1120 W 3Rd St # a
Chester, PA 19013-3622

Mailing address

1120 W 3Rd St # a
Chester, PA 19013-3622
Phone (215) 435-4203

Other identifiers 1

IdentifierTypeStateIssuer
1033772405MedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SecuredDatabaseFileServer Direct

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jesse Willard Woods III Multi-Specialty PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 1

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1750935987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W 3RD ST # A",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133622",
            "telephone_number": "215-435-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W 3RD ST # A",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133622",
            "telephone_number": "215-435-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBBALAA",
        "first_name": "MUHAMMAD L.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033772405",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SecuredDatabaseFileServer",
            "affiliation": "N",
            "endpointDescription": "PrecessFileServer",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1120 W 3rd St # A",
            "city": "Chester",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190133622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.