Wisam Al-Mutawalli, MD
NPI 1164005526ActiveIndividual· Family Medicine· Camillus, NY
Family Medicine (MD) with Select PT, OT and Slp Rehabilitation Ny, PLLC and 1 other group, practicing in Camillus, New York. Their prescriptions cost Medicare Part D more than their services did: $87,147 for 888 claims, against $11,390 paid for services in 2024. Lists Crouse Hospital and 2 other hospitals as hospital affiliations.
Overview
| NPI | 1164005526 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | May 4, 2021 |
| Last updated in NPPES | Oct 23, 2024 |
| Certified by provider | May 4, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 332191 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (NY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 60 |
|---|---|
| Services billed | 149 across 20 procedure codes |
| Paid by Medicare | $11,390 |
Part D prescriptions in 2024
| Prescriptions (claims) | 888 · 1,573 30-day fills |
|---|---|
| Patients | 200 |
| Total drug cost | $87,147 |
| Generic share | 85% of claims |
Education and affiliations
| Graduation year | 2005 |
|---|---|
| Medicare specialty | Family Practice |
| Telehealth | Offers telehealth |
Medical groups
- Select PT, OT and Slp Rehabilitation Ny, PLLCHudson, NY · 301 clinicians
- Upstate Family and Preventive Medicine IncSyracuse, NY · 29 clinicians
Hospital affiliations
- Crouse HospitalSyracuse, NY
- Oswego HospitalOswego, NY
- University Hospital S U N y Health Science CenterSyracuse, NY
Other facilities
- Centerwell Home HealthHome health agency · Liverpool, NY
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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