Individual provider Active NPI

Mohamado Musthaq, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1831115559
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD062265L Issued in PA
Practice address
520 N Columbus Blvd
Philadelphia, PA 19123-4226
Phone
(215) 923-8042
Fax
(215) 923-8064
NPI assigned
Jul 14, 2006
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD062265L PA Primary

Addresses

Primary practice location

520 N Columbus Blvd
Philadelphia, PA 19123-4226

Mailing address

505 Monticello LN
Plymouth Meeting, PA 19462-1275
Phone (484) 213-4712

Other identifiers 1

IdentifierTypeStateIssuer
568611-000OtherPAMIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070501000171 PA Practitioner - Psychiatry 0749386209 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Haven Behavioral Services of Philadelphia, LLCGroup PAC ID 8426297433, 6 clinicians
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

3300 Henry Ave
Unit 4
Philadelphia, PA 19129-1141
Phone (215) 475-3400

601 Roxbury Rd
Shippensburg, PA 17257-9302
Phone (888) 829-9974

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Pennsylvania Inc Psychiatry Current Accepting new patients
Uhs of Pennsylvania Inc Psychiatry CurrentSince Feb 18, 2014 Accepting new patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Jun 1, 2020 Accepting new patients
Haven Behavioral Services of Philadelphia, LLC CurrentSince Dec 1, 2016 Accepting new patients
The Neuropsychiatric Group Psychiatry PastSince Nov 1, 2001 Accepting new patients

Locations

800 Park Way
Ste A
Broomall, PA 19008
Phone (215) 718-4350

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

7170 Lafayette Ave
Ft Washington, PA 19034
Phone (215) 542-4343

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

601 Roxbury Rd
Shippensburg, PA 17257
Phone (717) 532-4217

3102 West End Ave
Ste 1000
Nashville, TN 37203

Organizations & group practices 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1831115559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 MONTICELLO LN",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621275",
            "telephone_number": "484-213-4712",
            "fax_number": "215-923-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N COLUMBUS BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234226",
            "telephone_number": "215-923-8042",
            "fax_number": "215-923-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTHAQ",
        "first_name": "MOHAMADO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD062265L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIS",
            "identifier": "568611-000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.