Individual provider Active NPI

Mustafa Muhammed Itani, MD

  • Pulmonary Disease Physician
  • Columbus, GA
National Provider Identifier
1770453052
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
112048 Issued in GA
Practice address
2300 Manchester Expy Ste 1009
Columbus, GA 31904-6877
Phone
(586) 413-6501
Fax
(833) 455-7724
NPI assigned
Nov 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 112048 GA Primary

Addresses

Primary practice location

2300 Manchester Expy Ste 1009
Columbus, GA 31904-6877

Mailing address

2300 Manchester Expy Ste 1009
Columbus, GA 31904-6877
Phone (586) 413-6501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260603003809 GA Practitioner - Pulmonary Disease 8628549342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2300 Manchester Expy
Columbus, GA 31904-6802
Phone (706) 324-7753

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
189256NYMDPulmonary Disease Physician

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": "1762819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1770453052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 1009",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046877",
            "telephone_number": "586-413-6501",
            "fax_number": "833-455-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 1009",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046877",
            "telephone_number": "586-413-6501",
            "fax_number": "833-455-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITANI",
        "first_name": "MUSTAFA",
        "middle_name": "MUHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-11",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "112048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.