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MUTSA NYAKABAU
NPI 1568859437
Pediatrics - Adolescent Medicine in Hagerstown, MD

Active since April 18, 2015PECOS Enrolled
201 S CLEVELAND AVE, HAGERSTOWN, MD 21740(301) 745-3777(301) 393-3459 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 12, 2023, Apr 9, 2019 (2 updates tracked since 2019).

About Mutsa Nyakabau NPPES

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

MUTSA NYAKABAU (NPI 1568859437) is an individual adolescent medicine provider in Hagerstown, Maryland, licensed in Maryland (D0085119) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568859437
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameMUTSA NYAKABAU
Location Address201 S CLEVELAND AVEHagerstown, MD 21740-5745
Mailing Address1502 Heather Hollow Cir, Apt. 34Silver Spring, MD 20904-2373 · (703) 869-2785
Phone(301) 745-3777
Fax(301) 393-3459
Sole ProprietorNo
Enumeration DateApril 18, 2015
Last NPPES UpdateJune 12, 20232 updates tracked since enumeration
NPPES CertifiedJune 12, 2023
✔ NPI 1568859437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in MD · D0085119
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
201 S CLEVELAND AVE, Hagerstown, MD 21740
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mutsa Nyakabau is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 18

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

DR. PAUL JOSEPH ANDREW HENNIS MD
Pediatrics
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777
MRS. CALISTA CHRISTINE DICKEY L. AC., DIPL. AC.
Acupuncturist
201 S CLEVELAND AVE, SUITE 404
HAGERSTOWN, MD 21740
Washington County (301) 797-2297
KATHRYN ANN GUFFIN RDH
Dental Hygienist
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777
WALNUT STREET COMMUNITY HEALTH CENTER
Dentist (Dental Public Health)
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777
KATHERINE GRUBER WAFER CRNP
Nurse Practitioner (Family)
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777
WALNUT STREET COMMUNITY HEALTH CENTER INC.
Clinic/Center (Dental)
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777
TIFFANI SARAH GRAVES
Dentist (General Practice)
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777
MS. SHARON ROSE MARREN LCSW-C
Social Worker (Clinical)
201 S CLEVELAND AVE
HAGERSTOWN, MD 21740
Washington County (301) 745-3777

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 Mutsa Nyakabau's NPI number?

The NPI number for Mutsa Nyakabau is 1568859437. It was assigned to this individual provider in the NPPES registry on April 18, 2015.

Where is Mutsa Nyakabau located?

Mutsa Nyakabau practices at 201 S Cleveland Ave, Hagerstown, MD 21740. The listed phone number is (301) 745-3777.

What is Mutsa Nyakabau's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Mutsa Nyakabau enrolled in Medicare?

Yes. Mutsa Nyakabau is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mutsa Nyakabau was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.