Individual provider Active NPI

Mobina Abdul Noory

  • Physician Assistant
  • Wilmington, DE
National Provider Identifier
1962867069
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057951 Issued in PA
Practice address
701 N Clayton St
Wilmington, DE 19805-3165
Phone
(302) 421-4100
NPI assigned
Dec 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA057951 PA Primary
Physician Assistant 363A00000X 25MP00385400 NJ
Physician Assistant 363A00000X C5-0001035 DE

Addresses

Primary practice location

701 N Clayton St
Wilmington, DE 19805-3165

Mailing address

404 Hummingbird LN
Bensalem, PA 19020-4644
Phone (267) 632-5661

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190703001258 PA Practitioner - Physician Assistant 6305190539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 890-3030

3998 Red Lion Rd
Philadelphia, PA 19114-1440

3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 992-6002

Hospital & facility affiliations

  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C5-0001035DEMDPhysician Assistant
25MP00385400NJMDPhysician Assistant
MA057951PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physicians Services - Emergency Medicine Physician Assistant CurrentSince May 11, 2019 Accepting new patients
Aria Health Physician Services CurrentSince May 11, 2019 Accepting new patients
Aria Health Physician Services Past Accepting new patients

Locations

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1962867069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 HUMMINGBIRD LN",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204644",
            "telephone_number": "267-632-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N CLAYTON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053165",
            "telephone_number": "302-421-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOORY",
        "first_name": "MOBINA",
        "middle_name": "ABDUL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057951",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00385400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001035",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.