Motaz Moussa, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

ME156847 Issued in FL

Practice address

410 Lionel Way Ste 201
Davenport, FL 33837-7809

Phone

(863) 422-5331

Fax

(863) 422-5336

NPI assigned

Feb 3, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Duke University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group Inc 953 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 5)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: mmoussa1693669@adventhealth.direct-ci.com

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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  FL

  Medicare reassignment Care Compare group NPD
• Trinity Cardiac Cath Lab LLC

  • Interventional Cardiology Physician
  • New Port Richey, FL
  • NPI 1215316625

  Cardiovascular Disease, FL

  Medicare reassignment NPD
• Usha Agarwal MD PA

  • Chronic Disease Hospital
  • Trinity, FL
  • NPI 1710306402
  NPD (past)

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

• Adventhealth Polk North Inc

  • General Acute Care Hospital
  • Davenport, FL
  • NPI 1801457510

  Hospital

  Care Compare affiliation
• Adventhealth Polk South Inc

  • General Acute Care Hospital
  • Lake Wales, FL
  • NPI 1053972760

  Hospital

  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071

  Hospital

  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1306178256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LIONEL WAY STE 201",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377809",
            "telephone_number": "863-422-5331",
            "fax_number": "863-422-5336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Farson St Ste 204A",
            "address_purpose": "LOCATION",
            "city": "Belpre",
            "state": "OH",
            "postal_code": "457141069",
            "country_code": "US",
            "telephone_number": "740-568-5207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Matthew St",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501644",
            "country_code": "US",
            "telephone_number": "740-568-5207",
            "fax_number": "740-568-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSSA",
        "first_name": "MOTAZ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-03",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.129093",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35.129093",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME156847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175394",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - MHCPI",
            "identifier": "P01784682",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "motaz.moussa@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "807 Farson St Ste 204A",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "motaz.moussa@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "400 Matthew St",
            "address_2": "Suite 302",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittany Moran
• Steffany Magnolia Morel Sandoval
• Angelica Sofia Moreno, MD
• Latoyia T Morrison
• Alain L Moulari
• Mrs Wanda Behavioral Consultant LLC
• Multispecialty Health Network of Florida, LLC
• Aglay Munoz Acosta, RBT
• Maria T Muriente, MD
• Gerard J Murphy, MD

• All providers in Davenport, FL
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.