Emad Y Mousa, MD

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

24508 Issued in WV

Practice address

77 Hospital Dr Ste 200
Logan, WV 25601-3451

Phone

(304) 896-5200

Fax

(304) 896-5300

NPI assigned

Jul 17, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OH, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Obstetrics/GynecologyAlso: Addiction Medicine, Family Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Logan Regional Medical Center Hospital, Logan, WV, CCN 510048

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alpha Omega Medical PLLC

  • Obstetrics Physician
  • Logan, WV
  • NPI 1497283352

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Alpha Medical Group LLC

  • Addiction Medicine (Family Medicine) Physician
  • Marion, OH
  • NPI 1265893549
  Medicare reassignment Authorized official
• Logan General Hospital LLC

  • General Acute Care Hospital
  • Logan, WV
  • NPI 1750332565
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Logan General Hospital LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Logan, WV
  • NPI 1295789675
  Care Compare affiliation
• Logan General Hospital LLC

  • General Acute Care Hospital
  • Logan, WV
  • NPI 1750332565
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1003070194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "25601",
            "telephone_number": "304-896-5200",
            "fax_number": "304-896-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL DR STE 200",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013451",
            "telephone_number": "304-896-5200",
            "fax_number": "304-896-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1043 Harding Memorial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "OH",
            "postal_code": "433026315",
            "country_code": "US",
            "telephone_number": "740-383-4090",
            "fax_number": "740-383-2850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSA",
        "first_name": "EMAD",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WV",
            "license": "24508",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35092078",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WV",
            "license": "24508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV MEDICARE",
            "identifier": "1003070194",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003070194",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11865318",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2873029",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Dawn Morrison
• Debrina Morton
• Mountaineer Family Medicine, Inc.
• Danielle Nicole Mounts
• Joseph Michael Mounts, M.ED., AADC, LPC
• William Mullen, D.O.
• Amanda A Mullins
• Beverly Mullins
• Cathy Mullins
• Katelyn Mullins

• Obstetrics Physician in Logan, WV
• Providers in Logan, WV by specialty
• Obstetrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.