DR. GHADA AL MUBARAK (M.D.) – Surgery Physician, NPI 1407034911
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,028 GENERAL SURGERY in MA
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Provider Addresses for DR. GHADA AL MUBARAK (M.D.)
790 EAST FIFTH STREET
COQUILLE, OR 974231666
Phone: (541) 396-3111
Fax: (541) 396-1783
Type: Mailing
750, Washington Street, Dorchester Center, Dorchester, Boston, Suffolk County, Massachusetts, 02124, United States
SURGERY DEPT, TUFTS-NEMC
BOSTON, MA 021111526
Phone: (617) 636-5891
Type: Location
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: 2025-02-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250128004418 | I | General Surgery | MD | TBD |
| I20250203001148 | I | General Surgery | DC | TBD |
| I20250224001735 | I | General Surgery | VA | TBD |
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.
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 97423)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Radiology, General Practice | VA | |
| Diagnostic Radiology, Interventional Radiology | IL | |
| General Surgery, Peripheral Vascular Disease, Vascular Surgery | DC |
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