NPIMap

Individual provider Active NPI

Mosta Gausel Haque, M.D.

  • Nephrology Physician
  • Portsmouth, VA
National Provider Identifier
1164465639
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101-048420 Issued in VA
Practice address
301 Goode Way
Suite 201
Portsmouth, VA 23704-2266
Phone
(757) 397-0700
Fax
(757) 397-8751
NPI assigned
Jun 13, 2006
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101-048420 VA
Nephrology Physician 207RN0300X 0101-048420 VA Primary

Addresses

Primary practice location

301 Goode Way
Suite 201
Portsmouth, VA 23704-2266

Mailing address

301 Goode Way
Suite 201
Portsmouth, VA 23704-2266
Phone (757) 397-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060131000836 VA Practitioner - NephrologyPractitioner - Internal Medicine 3779507488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 Goode Way
Suite 201
Portsmouth, VA 23704-2266
Phone (757) 397-0700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-048420VAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mosta G Haque MD PC Internal Medicine CurrentSince Jan 1, 2006 Accepting new patients

Locations

301 Goode Way
Ste 201
Portsmouth, VA 23704
Phone (757) 397-0700

Organizations & group practices 1

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1164465639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GOODE WAY",
            "address_2": "SUITE 201",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042266",
            "telephone_number": "757-397-0700",
            "fax_number": "757-397-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GOODE WAY",
            "address_2": "SUITE 201",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042266",
            "telephone_number": "757-397-0700",
            "fax_number": "757-397-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "MOSTA",
        "middle_name": "GAUSEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101-048420",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101-048420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.