Individual provider Active NPI

Musab Mukhtar

  • Driver
  • Tigard, OR
National Provider Identifier
1982459178
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
11022 SW 74TH Ave
Tigard, OR 97223-2707
Phone
(971) 401-9876
NPI assigned
Apr 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X Primary

Addresses

Primary practice location

11022 SW 74TH Ave
Tigard, OR 97223-2707

Mailing address

11022 SW 74TH Ave
Tigard, OR 97223-2707
Phone (971) 401-9876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1982459178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 SW 74TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232707",
            "telephone_number": "971-401-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 SW 74TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232707",
            "telephone_number": "971-401-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHTAR",
        "first_name": "MUSAB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.