Individual provider Active NPI

Mostafa El Ghissassi, MD

  • Pediatrics Physician
  • Plantation, FL
National Provider Identifier
1114017811
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME152727 Issued in FL
Practice address
9611 W Broward Blvd
Plantation, FL 33324-2334
Phone
(954) 924-7000
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME152727 FL Primary
Pediatrics Physician 208000000X 226312 NY

Addresses

Primary practice location

9611 W Broward Blvd
Plantation, FL 33324-2334

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 281-9065

Other practice location 1

11260 Sullivan St
Riverview, FL 33578-2140
Phone (813) 689-7571

Other practice location 2

91 Chenango Bridge Rd
Binghamton, NY 13901-1293
Phone (607) 648-6667

Other practice location 3

4972 Town Center Pkwy Unit 301
Jacksonville, FL 32246-8596
Phone (904) 642-6100

Other identifiers 1

IdentifierTypeStateIssuer
02676355MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Mostafa.ElGhissassiMD@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250211000747 FL Practitioner - Pediatric Medicine 4688638232 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Jan 30, 2025 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 30, 2025 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Clearwater, FL 33759
Phone (727) 315-7496

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

10330 N Dale Mabry Hwy
Ste 190
Tampa, FL 33618
Phone (813) 969-4440

Interoperability endpoints

  • Direct secure messaging: mostafa.elghissassimd@direct.mybaycare.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1114017811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9611 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242334",
            "telephone_number": "954-924-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11260 Sullivan St",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335782140",
            "country_code": "US",
            "telephone_number": "813-689-7571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "91 Chenango Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139011293",
            "country_code": "US",
            "telephone_number": "607-648-6667",
            "fax_number": "607-648-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4972 Town Center Pkwy Unit 301",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322468596",
            "country_code": "US",
            "telephone_number": "904-642-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EL GHISSASSI",
        "first_name": "MOSTAFA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME152727",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "226312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02676355",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mostafa.ElGhissassiMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11260 Sullivan St",
            "city": "Riverview",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335782140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.