Individual provider Active NPI

Tarek Mohamed Mousa, MD, PHD

  • Cardiovascular Disease Physician
  • Astoria, NY
National Provider Identifier
1013177757
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
259363 Issued in NY
Practice address
2427 Steinway St
Astoria, NY 11103-3654
Phone
(929) 208-0080
Fax
(929) 208-0010
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 259363 NY Primary

Addresses

Primary practice location

2427 Steinway St
Astoria, NY 11103-3654

Mailing address

2427 Steinway St
Astoria, NY 11103-3654
Phone (929) 208-0080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121210000192 NY Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0941452478 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140

2427 Steinway St
Astoria, NY 11103-3654
Phone (347) 556-7769

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
259363NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical of Brooklyn PC CurrentSince Feb 3, 2016 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 19, 2023 Accepting new patients
Laurelton Heart Specialist P.C. Cardiovascular Disease CurrentSince Jun 1, 2012 Accepting new patients
North Shore-Lij Medical PC Cardiovascular Disease CurrentSince Jul 19, 2023 Accepting new patients
Ismail Ozcan MD PC CurrentSince Nov 1, 2014 Accepting new patients

Locations

1001 Route 70
Ste 127
Toms River, NJ 08755

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

122 Portion Rd
Ronkonkoma, NY 11779
Phone (631) 588-6665

23436 Merrick Blvd
Rosedale, NY 11422
Phone (718) 949-9400

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: tmousa64521@northwell.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1013177757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033654",
            "telephone_number": "929-208-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033654",
            "telephone_number": "929-208-0080",
            "fax_number": "929-208-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSA",
        "first_name": "TAREK",
        "middle_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "259363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.