ANWAR NAKKOUL MD, PC
NPI 1053444018
Internal Medicine in Ashland, PA
About Anwar Nakkoul Md, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANWAR NAKKOUL MD, PC (NPI 1053444018) is a healthcare organization registered as an internal medicine in Ashland, Pennsylvania and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through January 1, 2028 and lists Nicole Blase, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Anwar Nakkoul Md, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Anwar Nakkoul MD, PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 39D2177017
Anwar Nakkoul, MD · Ashland, PAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Anwar Nakkoul MD, PC's NPI number?
The NPI number for Anwar Nakkoul MD, PC is 1053444018. It was assigned to this organization in the NPPES registry on March 13, 2007.
Where is Anwar Nakkoul MD, PC located?
Anwar Nakkoul MD, PC is located at 1023 Centre St, Ashland, PA 17921. The listed phone number is (570) 875-3665.
What is Anwar Nakkoul MD, PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Anwar Nakkoul MD, PC enrolled in Medicare?
Yes. Anwar Nakkoul MD, PC is registered in the Medicare PECOS enrollment system.
When is Anwar Nakkoul MD, PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Anwar Nakkoul MD, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Anwar Nakkoul MD, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Anwar Nakkoul MD, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 39D2177017) is associated with this NPI, valid through January 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Anwar Nakkoul MD, PC was last updated on June 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Anwar Nakkoul Md, Pc · NPI 1053444018
Internal Medicine organization in Ashland, Pennsylvania. Organization record, active in the CMS NPPES registry since March 13, 2007.
## Identity
- **NPI:** 1053444018 (Entity type: Organization)
- **Enumerated:** March 13, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Nicole Blase, OFFICE MANAGER
## Practice location
- **Address:** 1023 CENTRE ST, Ashland, PA 17921-1204
- **Phone:** (570) 875-3665 · **Fax:** (570) 875-2012
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 29, 2010
- **Other identifiers:** Medicare UPIN G03491 (PA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053444018) · Data from the CMS NPPES public registry.