Individual provider Active NPI

Anique Mustafa, M.D.

  • Internal Medicine Physician
  • Plantation, FL
National Provider Identifier
1104314889
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME167365 Issued in FL
Practice address
8201 W Broward Blvd
Plantation, FL 33324-2701
Phone
(877) 832-2652
Fax
(800) 792-9021
NPI assigned
Apr 27, 2018
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30599 WV
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME167365 FL Primary

Addresses

Primary practice location

8201 W Broward Blvd
Plantation, FL 33324-2701

Mailing address

4960 SW 72ND Ave Ste 301
Miami, FL 33155-5549
Phone (877) 832-2652

Other practice location 1

4605 MacCorkle Ave SW
South Charleston, WV 25309-1398
Phone (617) 396-0753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20210916003052 WV Practitioner - Internal Medicine 2860899945 Reassigns benefits to 1 organization
I20240726003449 FL Practitioner - Internal Medicine 2860899945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HHA Associates LLCGroup PAC ID 2961839758, 125 clinicians

Practice addresses (Care Compare)

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 476-3911

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HHA Associates LLC CurrentSince Aug 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of West Virginia- TCG PLLC Internal Medicine CurrentSince Feb 12, 2022 Accepting new patients

Locations

3476 S University Dr
Davie, FL 33328
Phone (954) 475-4346

4960 SW 72nd Ave
Ste 301
Miami, FL 33155

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1104314889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555549",
            "telephone_number": "877-832-2652",
            "fax_number": "800-792-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242701",
            "telephone_number": "877-832-2652",
            "fax_number": "800-792-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 MacCorkle Ave SW",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091398",
            "country_code": "US",
            "telephone_number": "617-396-0753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "ANIQUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "30599",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME167365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.