Individual provider Active NPI

Mousson Berrouet, DO

  • Family Medicine Physician
  • Odenton, MD
National Provider Identifier
1154987170
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0095795 Issued in MD
Practice address
1110 Annapolis Rd
Odenton, MD 21113-1602
Phone
(443) 351-3917
NPI assigned
May 15, 2019
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230124003339 MD Practitioner - Family PracticePractitioner - Emergency Medicine 7911378203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0095795MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 20, 2024 Accepting new patients
Vohra Post Acute Care Physicians of the East, PA Family Medicine CurrentSince Jan 20, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 20, 2024 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.

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

Verify at the official NPI Registry.