Michael Dominic Mozzetti Sr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME069032 Issued in FL

Practice address

3161 Harbor Blvd
Suite a
Port Charlotte, FL 33952-6754

Phone

(941) 629-1218

Fax

(941) 625-9465

NPI assigned

Dec 6, 2006

Last updated

Mar 22, 2017By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

Practice roles

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.

• Express Care Medical Clinic

  • Family Medicine Physician
  • Port Charlotte, FL
  • NPI 1295904571
  Authorized official Same address or phone
• Michael D Mozzetti MD PL

  dba Express Care Medical Cinic

  • Family Medicine Physician
  • Port Charlotte, FL
  • NPI 1003073214
  Authorized official Same address or phone
• Gulf Coast Emergency Physicians PA

  • Emergency Medicine Physician
  • Port Charlotte, FL
  • NPI 1518989318
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1265591259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 HARBOR BLVD",
            "address_2": "SUITE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526754",
            "telephone_number": "941-629-1218",
            "fax_number": "941-625-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 HARBOR BLVD",
            "address_2": "SUITE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526754",
            "telephone_number": "941-629-1218",
            "fax_number": "941-625-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZZETTI",
        "first_name": "MICHAEL",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME069032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "32306",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morningstar Medical Group
• Alycia Anne Mosley, AP
• Eric Movshin
• David Alan Mowry
• Dwight E Moxley, CRNA
• Denise Mueller-Barker, ARNP
• Muhammed Y Memon MD PA
• Tracy M Mullins, PTA
• Joshua A Multack, D.O.
• Lianet Munguia Zaragoza

• Family Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.