Active NPI
Mosta Gausel Haque, M.D.
- Nephrology Physician
- Portsmouth, VA
National Provider Identifier
1164465639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 0101-048420
- Practice address
- 301 Goode Way
Suite 201
Portsmouth, VA 23704-2266 - Phone
- (757) 397-0700
- Fax
- (757) 397-8751
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| 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
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010236801 | Medicaid | VA | |
| 187692 | Other | VA | ANTHEM BC /BS |
| P00273296 | Other | VA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- 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
- DaVita Harbour View Dialysis
- DaVita Greater Portsmouth Dialysis
- Bon Secours Maryview Medical Center
- Bon Secours Harbour View Medical Center
- Chesapeake General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101-048420 | VA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mosta G Haque MD PC | Internal Medicine | Current | 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 and National Provider Directory roles.
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Portsmouth, VA
- NPI 1275597429
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Suffolk, VA
- NPI 1316186299
Dialysis facility
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1003265075
-
- General Acute Care Hospital
- Chesapeake, VA
- NPI 1700896354
-
- General Acute Care Hospital
- Suffolk, VA
- NPI 1104658434
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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010236801",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC /BS",
"identifier": "187692",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00273296",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
- Kristy Klima Hansen, PHARMD
- Todd Phillip Hansen, M.D., PH.D.
- Patricia Ippolito Hanson, CNM
- Shannon J. Hanvey, P.A.
- Faheem Haque, PHARM. D.
- Harbor Point Behavioral Health Center Inc
- Harbor Point Behavioral Health Center Inc
- Harbor Point Behavioral Health Center, Inc
- Harbour Healthcare Inc.
- Andrew Wolfe Harbuck, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.