Christie O Mousaw, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS 012760 Issued in PA

Practice address

300 Evergreen Dr
Suite 310
Glen Mills, PA 19342-1059

Phone

(610) 579-3564

Fax

(610) 579-3566

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Christie Lynn O'Neill Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Paoli Hospital Hospital, Paoli, PA, CCN 390153

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD

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

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1265539050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EVERGREEN DR",
            "address_2": "SUITE 310",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421059",
            "telephone_number": "610-579-3555",
            "fax_number": "610-579-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EVERGREEN DR",
            "address_2": "SUITE 310",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421059",
            "telephone_number": "610-579-3564",
            "fax_number": "610-579-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSAW",
        "first_name": "CHRISTIE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS 012760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101720742",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIE",
            "last_name": "O'NEILL",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vincent D Mongiovi, D.M.D.
• Ann E Moore, CRNP
• Jane Ruth Moore, OTRL CHT
• Joel G Moranz, MD
• Jasoni Lee Morgan, CRNP
• Nicole Mowbray, PSY.D
• Chantel Priolo Mozal, MPH, PA-C
• Grace Mulcahy
• Kelly Mullan
• Denise A Mulvaney, MD

• Family Medicine Physician in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.

Verify at the official NPI Registry.