Active NPI
Mousson Berrouet, DO
- Family Medicine Physician
- Odenton, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H0095795
- Practice address
- 1110 Annapolis Rd
Odenton, MD 21113-1602 - Phone
- (443) 351-3917
- NPI assigned
- May 15, 2019
- Last updated
- Apr 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | H0095795 | MD | Primary |
Addresses
Primary practice location
1110 Annapolis Rd
Odenton, MD 21113-1602
Mailing address
5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 822-4355
Other practice location 1
The Wright Center
111 N. Washington Avenue, Suite 1
Scranton, PA 18503
Phone (570) 343-2383
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MDExchange@patientfirstclinics.com | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H0095795 | MD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Vohra Post Acute Care Physicians of the East, PA | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients |
Locations
3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951
888 Bestgate Rd
Annapolis, MD 21401
Phone (410) 571-7300
10320 Little Patuxent Pkwy
Ste 200
Columbia, MD 21044
Phone (703) 988-2360
7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600
2101 E Jefferson St
#4E
Rockville, MD 20852
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Health Maintenance Organization
- Halethorpe, MD
- NPI 1043378656
-
- Family Medicine Physician
- Miramar, FL
- NPI 1063848968
MD
-
dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1154987170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 COX RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230609263",
"telephone_number": "804-822-4355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 ANNAPOLIS RD",
"city": "ODENTON",
"state": "MD",
"postal_code": "211131602",
"telephone_number": "443-351-3917"
}
],
"practiceLocations": [
{
"address_1": "The Wright Center",
"address_2": "111 N. Washington Avenue, Suite 1",
"address_purpose": "LOCATION",
"city": "Scranton",
"state": "PA",
"postal_code": "18503",
"country_code": "US",
"telephone_number": "570-343-2383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERROUET",
"first_name": "MOUSSON",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "H0095795",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MDExchange@patientfirstclinics.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1110 Annapolis Rd",
"city": "Odenton",
"state": "MD",
"country_code": "US",
"postal_code": "211131602",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "The Wright Center",
"address_2": "111 N. Washington Avenue, Suite 1",
"city": "Scranton",
"state": "PA",
"country_code": "US",
"postal_code": "18503",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Odenton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.