Active NPI
Mutaz Alkalbani, MD
- Student in an Organized Health Care Education/Training Program
- Norfolk, VA
National Provider Identifier
1811558786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 721 Fairfax Ave Apt a
Norfolk, VA 23507-2007 - Phone
- (757) 446-7934
- NPI assigned
- Jun 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
721 Fairfax Ave Apt a
Norfolk, VA 23507-2007
Mailing address
612 Fairfax Ave Apt a
Norfolk, VA 23507-2075
Phone (917) 624-7393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190711001541 | VA | Order and Referring Only - Internal Medicine | 6305171489 |
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8095 Innovation Park Dr
Fairfax, VA 22031-4868
Hospital & facility affiliations
- Inova Fairfax Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1811558786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 FAIRFAX AVE APT A",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235072075",
"telephone_number": "917-624-7393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 FAIRFAX AVE APT A",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235072007",
"telephone_number": "757-446-7934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALKALBANI",
"first_name": "MUTAZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-21",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.