Azza Abubaker
Individual provider Active NPI Nephrology Physician · Philadelphia, PA
NPI 1821732298 · NPPES record last updated Apr 22, 2022
Key facts
- NPI
- 1821732298
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- MT224765 (PA)
- Practice address
- 111 S 11TH St
Philadelphia, PA 19107-4824 - Phone
- (215) 955-4294
- NPI assigned
- Apr 22, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220502001535 | PA | Order and Referring Only - Nephrology |
6406243971 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MT224765 | PA | Yes |
Addresses
Primary practice location
111 S 11TH St
Philadelphia, PA 19107-4824
Mailing address
111 S 11TH St
Philadelphia, PA 19107-4824
Phone (215) 955-4294
Other providers in Philadelphia, PA
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- Matenneh Abu
- Sherin Abu
- Katrina Elaine Abuabara
- Mayssa Abuali
- Natalie Abulhawa
- John Abulu
- Abundant Comfort Care
- Abundant Home Health Services
- Abundant Life Home Health Services
All providers in Philadelphia, PA · Nephrology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.