NPIMap

Individual provider Active NPI

George Mousa, MD

  • Internal Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1144711821
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A180582 Issued in CA
Practice address
401 E 21St St
San Bernardino, CA 92404-4845
Phone
(909) 881-3333
NPI assigned
May 29, 2018
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A180582 CA Primary

Addresses

Primary practice location

401 E 21St St
San Bernardino, CA 92404-4845

Mailing address

401 E 21St St
San Bernardino, CA 92404-4845
Phone (909) 881-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220909001019 CA Practitioner - Internal Medicine 8022368323 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 883-8711

401 E 21St St
San Bernardino, CA 92404-4845
Phone (909) 881-3333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A180582CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd MD Prof Inc Current Accepting new patients
Beaver Medical Group P C CurrentSince Oct 21, 2022 Accepting new patients
Beaver Medical Group P C Internal Medicine CurrentSince Oct 21, 2022 Accepting new patients
George Mousa MD Prof Inc Internal Medicine CurrentSince Jul 9, 2023 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients
Redlands Community Hospital Past Accepting new patients
Beaver Medical Group P C Internal Medicine Past Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients

Locations

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

401 E 21st St
Sn Bernrdno, CA 92404
Phone (909) 881-3333

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

440 N Mountain Ave
Ste 301
Upland, CA 91786
Phone (909) 738-3500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: george.mousa.1@13014.direct.athenahealth.com
  • Direct secure messaging: gmousa22142@epiclp.direct-ci.com
  • Direct secure messaging: gmousa567489@direct.llu.edu
  • FHIR API: https://api.platform.athenahealth.com/22547/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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 4

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1144711821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 21ST ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044845",
            "telephone_number": "909-881-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 21ST ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044845",
            "telephone_number": "909-881-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSA",
        "first_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A180582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.