NPIMap

Individual provider Active NPI

Shafik Hanna-Moussa, MD

  • Interventional Cardiology Physician
  • Longview, TX
National Provider Identifier
1306850227
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
N7098 Issued in TX
Practice address
703 E Marshall Ave Ste 5008
Longview, TX 75601-5557
Phone
(903) 315-4880
Fax
(903) 315-2833
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036-114818 IL
Cardiovascular Disease Physician 207RC0000X N7098 TX
Interventional Cardiology Physician 207RI0011X N7098 TX Primary

Addresses

Primary practice location

703 E Marshall Ave Ste 5008
Longview, TX 75601-5557

Mailing address

PO Box 4207
Longview, TX 75606-4207
Phone (903) 315-4880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101004001059 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9739103052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

701 E Marshall Ave
410 Christus Trinity Clinic
Longview, TX 75601-5595
Phone (903) 236-4115

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting25
Leg revascularization (restoring blood flow)18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-114818ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients
Christus Trinity Clinic Texas Cardiovascular Disease CurrentSince Jul 1, 2017 Accepting new patients
Heartcare Midwest , LTD Cardiovascular Disease Past Accepting new patients
Marshall Health Services Inc PastSince Sep 26, 2012 Accepting new patients
Heartcare Midwest Past Accepting new patients
St Joseph Medical Center Past Accepting new patients

Locations

1600 Broadway Ave
Gladewater, TX 75647
Phone (903) 315-5630

701 E Marshall Ave
Ste 410
Longview, TX 75601
Phone (903) 236-4115

703 E Marshall Ave
Ste 5008
Longview, TX 75601
Phone (903) 315-4800

707 E Marshall Ave
Longview, TX 75601
Phone (903) 315-4880

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: shannamoussa149565@christushealth.direct-ci.net

Organizations & group practices 6

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 4

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306850227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4207",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756064207",
            "telephone_number": "903-315-4880",
            "fax_number": "903-315-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 E MARSHALL AVE STE 5008",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015557",
            "telephone_number": "903-315-4880",
            "fax_number": "903-315-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA-MOUSSA",
        "first_name": "SHAFIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-114818",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "N7098",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "N7098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.