Mousson Berrouet, DO
Individual provider Active NPI Family Medicine Physician · Odenton, MD
NPI 1154987170 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1154987170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- H0095795 (MD)
- Practice address
- 1110 Annapolis Rd
Odenton, MD 21113-1602 - Phone
- (443) 351-3917
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230124003339 | MD | Practitioner - Family Practice |
7911378203 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting 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 |
Locations
3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951
888 Bestgate Rd
Annapolis, MD 21401
Phone (410) 571-7300
7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600
10320 Little Patuxent Pkwy
Ste 200
Columbia, MD 21044
Phone (703) 988-2360
2101 E Jefferson St
#4E
Rockville, MD 20852
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | H0095795 | MD | Yes |
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
| 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) |
Other providers in Odenton, MD
- Nicole Behrle
- Joseph Zvi Benderson
- Markisha Theressa Bennett
- Andrea Benvenuto
- Barry I Bercovitz
- Madelyn Rose Berry
- Daijon Bibbs
- Maria Bieberich
- Rachel Blaustein
- Adrienne Boettinger
All providers in Odenton, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.