DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) – Transplant Hepatology Physician, NPI 1477880508

DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) is a healthcare provider. based in Salt lake city, Utah. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. MD60583720 (WA). The NPI Number for DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) is 1477880508

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.)
NPI
1477880508
Phone
(206) 320-4476
Address
PO BOX 25608
Enumeration Date
10 November 2009
Last Update Date
17 December 2021

Doctor Profile

Medical School Name
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4158332871
Graduation Year
2009 (17 years ago)
PAC ID
0446573273
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20141230001733
Address ID
CA941153305SA2350XBLVD300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness85
Years active:16State licenses:1Other namesUpdated within 12 months

4,056 INTERNAL MEDICINE in WA

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Provider Addresses for DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.)

  • PO BOX 25608

    SALT LAKE CITY, UT 841250608

    Phone: (206) 320-4476

    Fax: (206) 568-7043

    Type: Mailing

  • Medical Pavilion, 1124, Columbia Street, First Hill, Seattle, King County, Washington, 98104, United States

    SUITE 600

    SEATTLE, WA 981042026

    Phone: (206) 386-3660

    Fax: (206) 386-3644

    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: 2014-12-30

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
I20141230001733IInternal MedicineCATBD

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 84125)

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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: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

How is DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) with NPI 1477880508.
Is DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) still practicing?
DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) is currently listed as active in the public NPI registry.
What is DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.)'s specialty?
The listing groups DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.) with Transplant Hepatology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.)?
DR. NIZAR ABDELRAHMAN MUKHTAR (M.D.)'s geographic hint is Salt Lake City, Utah in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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