Saad Mossallati, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

WV13308 Issued in WV

Practice address

527 Medical Park Drive
Suite 204
Bridgeport, WV 26330

Phone

(304) 933-3800

Fax

(304) 933-3815

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medbrook Medical Associates Inc

  • Family Medicine Physician
  • Bridgeport, WV
  • NPI 1013960632
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1003900283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSALLATI",
        "first_name": "SAAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WV",
            "license": "WV13308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128388000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110025127",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000421910",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helen Elizabeth Morgan
• Jo-Clair Morgan, OTR/L
• Megan Morgan
• Morgantown Orthotic & Prosthetic Center, Inc
• Jordan Renee Morrison, OPTICIAN
• Mountain Laurel Psychiatry LLC
• Mountain Momma & Family Services, LLC
• Mountain River Physical Therapy, LLC
• Mountain State Medical Specialties, PLLC
• Mountain State Medical Specialties,Inc.

• All providers in Bridgeport, WV
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.