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MBOUTIDEM ETOKAKPAN MD
NPI 1467851634
Surgery in Hazle Township, PA

Active since August 14, 2014PECOS EnrolledAccepts Medicare Assignment
50 MOISEY DR, HAZLE TOWNSHIP, PA 18202(570) 501-6900(570) 501-6945 Get Directions Write a Review

NPPES record last updated: July 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 26, 2022, Jul 27, 2020 (2 updates tracked since 2020).

About Mboutidem Etokakpan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MBOUTIDEM ETOKAKPAN MD (NPI 1467851634) is an individual surgery provider in Hazle Township, Pennsylvania, licensed in Pennsylvania (MD469829) and active in the NPI registry since August 2014. He is enrolled in Medicare PECOS, is affiliated with Lehigh Valley Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1467851634
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMBOUTIDEM ETOKAKPANCredential: MD
Location Address50 MOISEY DRHazle Township, PA 18202-9297
Mailing Address2100 Mack Blvd Fl 4Allentown, PA 18103-5622 · (570) 501-6368 · Fax (570) 501-4754
Phone(570) 501-6900
Fax(570) 501-6945
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateAugust 14, 2014
Last NPPES UpdateJuly 26, 20222 updates tracked since enumeration
NPPES CertifiedJuly 26, 2022
✔ NPI 1467851634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in PA · MD469829✔ Licensed in OH · 35.138339
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
50 MOISEY DR, Hazle Township, PA 18202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mboutidem Etokakpan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284937442
PECOS Enrollment IDI20220813000831
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
64 services64 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
48 services36 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
39 services35 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
38 services20 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
22 services21 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
22 services22 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

Lehigh Valley Hospital - Hazleton

Acute Care Hospitals · Hazleton, PA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number390185
Location700 East Broad StreetHazleton, PA 18201 · Luzerne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALYSSA JO WILLIAMS RDN, LDN
Dietitian, Registered
50 MOISEY DR
HAZLE TOWNSHIP, PA 18202
Luzerne County (570) 501-6206
BEN IVEY
Speech-Language Pathologist
50 MOISEY DR
HAZLE TOWNSHIP, PA 18202
Luzerne County (570) 501-6754
HAILEY DWYER PA-C
Physician Assistant
50 MOISEY DR
HAZLE TOWNSHIP, PA 18202
Luzerne County (570) 501-6600
MOLLY ANN SWEENEY MS, RDN, LDN, CDE
Dietitian, Registered
50 MOISEY DR
HAZLE TOWNSHIP, PA 18202
Luzerne County (570) 501-6206
HAZLETON HEALTH & WELLNESS CENTER
Radiology (Diagnostic Radiology)
50 MOISEY DR
HAZLETON, PA 18202
Luzerne County (570) 501-4000
MS. JENNA ANGELA BARTEL WHNP-BC,CRNP
Nurse Practitioner (Women's Health)
50 MOISEY DR
HAZLE TOWNSHIP, PA 18202
Luzerne County (570) 501-6400
LEEANN YETTER
Audiologist
50 MOISEY DR
HAZLE TOWNSHIP, PA 18202
Luzerne County (570) 459-5030
MR. WILLIAM FRANCIS DESSOYE III MSPT
Physical Therapist
50 MOISEY DR
HAZLETON, PA 18202
Luzerne County (570) 501-6767

Frequently 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 Mboutidem Etokakpan's NPI number?

The NPI number for Mboutidem Etokakpan is 1467851634. It was assigned to this individual provider in the NPPES registry on August 14, 2014.

Where is Mboutidem Etokakpan located?

Mboutidem Etokakpan practices at 50 Moisey Dr, Hazle Township, PA 18202. The listed phone number is (570) 501-6900.

What is Mboutidem Etokakpan's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Mboutidem Etokakpan enrolled in Medicare?

Yes. Mboutidem Etokakpan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mboutidem Etokakpan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan and CareSource list Mboutidem Etokakpan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mboutidem Etokakpan affiliated with any hospitals?

According to CMS data, Mboutidem Etokakpan is affiliated with Lehigh Valley Hospital and Lehigh Valley Hospital - Hazleton.

When was this NPI record last updated?

The NPPES record for Mboutidem Etokakpan was last updated on July 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.