TALA MOHD ENEIZAT MAHDAWI (MD) – Student in an Organized Health Care Education/Training Program, NPI 1619462728

TALA MOHD ENEIZAT MAHDAWI (MD) is a healthcare provider. based in Boston, Massachusetts. specializing in PULMONARY DISEASE. They hold the professional credentials MD. The NPI Number for TALA MOHD ENEIZAT MAHDAWI (MD) is 1619462728

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
TALA MOHD ENEIZAT MAHDAWI (MD)
NPI
1619462728
Phone
Not provided
Address
736 CAMBRIDGE ST
Enumeration Date
30 June 2018
Last Update Date
30 June 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2195955754
Graduation Year
2015 (11 years ago)
PAC ID
3274057146
Group Practice PAC ID
0143537308
Professional Enrollment ID
I20250412000129
Address ID
IN463215754MU501XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

790 PULMONARY DISEASE in MA

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Provider Addresses for TALA MOHD ENEIZAT MAHDAWI (MD)

  • St. Elizabeth's Medical Center, 736, Cambridge Street, Aberdeen, Brighton, Boston, Suffolk County, Massachusetts, 02135, United States

    BOSTON, MA 021352907

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250412000129IPulmonary DiseaseINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02135)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143537308View full group profile
NameSpecialtyState
Internal MedicinePA
Critical Care (Intensivists), Pulmonary DiseaseIL
Pulmonary Disease, Internal Medicine, Sleep MedicineIN

Reviews

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Frequently asked questions

What is TALA MOHD ENEIZAT MAHDAWI (MD)'s NPI number?
TALA MOHD ENEIZAT MAHDAWI (MD)'s NPI is 1619462728 — the number used across U.S. healthcare to identify this provider.
Is TALA MOHD ENEIZAT MAHDAWI (MD) still an active registrant?
TALA MOHD ENEIZAT MAHDAWI (MD) carries an active NPI according to the public dataset.
What kind of doctor is TALA MOHD ENEIZAT MAHDAWI (MD)?
TALA MOHD ENEIZAT MAHDAWI (MD) is associated with Student in an Organized Health Care Education/Training Program in the directory — Clinical services aligned with this taxonomy classification.
Is TALA MOHD ENEIZAT MAHDAWI (MD) located near Boston?
TALA MOHD ENEIZAT MAHDAWI (MD) currently maps to Boston, Massachusetts in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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