Individual provider Active NPI

Mohamed Abou Shousha, MD

  • Ophthalmology Physician
  • Saint Louis, MO
National Provider Identifier
1174839583
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2011017310 Issued in MO
Practice address
1755 S Grand Blvd
Saint Louis, MO 63104-1540
Phone
(305) 243-2020
NPI assigned
Aug 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MFC1668 FL
Ophthalmology Physician 207W00000X 2011017310 MO Primary

Addresses

Primary practice location

1755 S Grand Blvd
Saint Louis, MO 63104-1540

Mailing address

1755 S Grand Blvd
Saint Louis, MO 63104-1540
Phone (305) 243-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000358 FL Practitioner - Ophthalmology 1557559168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

900 NW 17TH St 5TH FLR
Uhealth Sleep Center Bpei
Miami, FL 33136-1119
Phone (305) 243-5512

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2011017310MOMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Past Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

900 NW 17th St
Miami, FL 33136
Phone (305) 243-6605

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

900 NW 17th St
Fl 5
Miami, FL 33136
Phone (561) 515-1500

900 NW 17th St
Fl 2
Miami, FL 33136
Phone (305) 326-6170

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

7101 Fairway Dr
West Palm Beach, FL 33418
Phone (561) 515-1500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: maboushousha10836@direct.med.miami.edu

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1174839583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041540",
            "telephone_number": "305-243-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041540",
            "telephone_number": "305-243-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU SHOUSHA",
        "first_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-23",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "MFC1668",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2011017310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.