NPIMap

Individual provider Active NPI

Mohamed Husam Shitia, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Scranton, PA
National Provider Identifier
1861996555
Registry record updated Jun 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
OS022919 Issued in PA
Practice address
300 Lackawanna Ave
Scranton, PA 18503-2001
Phone
(570) 961-3823
NPI assigned
Mar 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 34.015381 OH
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 0102207057 VA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X OS022919 PA Primary

Addresses

Primary practice location

300 Lackawanna Ave
Scranton, PA 18503-2001

Mailing address

300 Lackawanna Ave Ste 250
Scranton, PA 18503-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, VA, PA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220202000642 OH Practitioner - General Practice 4880940386 Reassigns benefits to 1 organization
I20220503000063 VA Practitioner - Physical Medicine and Rehabilitation 4880940386 Reassigns benefits to 1 organization
I20230822001573 PA Practitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 4880940386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Physical Medicine and Rehabilitation
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

300 Lackawanna Ave
Scranton, PA 18503-2001
Phone (570) 961-3823

Hospital & facility affiliations

  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Allied Services Institute of Rehabilitation Inpatient rehabilitation facility, Scranton, PA, CCN 393030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.015381OHMDSports Medicine (Physical Medicine & Rehabilitation) Physician
0102207057VAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC CurrentSince Aug 1, 2023 Accepting new patients
Geisinger Clinic CurrentSince Aug 1, 2023 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger-HM Joint Venture, LLC Current Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Aug 1, 2023 Accepting new patients
Academic Primary Care Associates Neuromusculoskeletal Medicine & Omm CurrentSince Jun 1, 2022 Accepting new patients
Geisinger Clinic CurrentSince Aug 1, 2023 Accepting new patients
Academic Primary Care Associates CurrentSince Jun 1, 2022 Accepting new patients
Signify Health, LLC General Practice CurrentSince Jan 1, 2022 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

300 Lackawanna Ave
Scranton, PA 18503
Phone (570) 342-7864

300 Lackawanna Ave
Ste 250
Scranton, PA 18503
Phone (570) 961-3823

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1691 Innovation Dr
Ste 2100
Blacksburg, VA 24060
Phone (540) 232-8405

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26460/brand/1/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717891200000",
    "number": "1861996555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LACKAWANNA AVE STE 250",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185032001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LACKAWANNA AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185032001",
            "telephone_number": "570-961-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHITIA",
        "first_name": "MOHAMED",
        "middle_name": "HUSAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2024-06-09",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OH",
            "license": "34.015381",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "VA",
            "license": "0102207057",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "OS022919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.