Individual provider Active NPI

Moustafa S Shamma, M.D.

  • General Practice Physician
  • Lanham, MD
National Provider Identifier
1336149632
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D43690 Issued in MD
Practice address
8118 Good Luck Rd
Lanham, MD 20706-3574
Phone
(301) 552-8665
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0043690 MD
Internal Medicine Physician 207R00000X D43690 MD
General Practice Physician 208D00000X D43690 MD Primary

Addresses

Primary practice location

8118 Good Luck Rd
Lanham, MD 20706-3574

Mailing address

6400 Marlboro Pike
District Heights, MD 20747-2841
Phone (301) 736-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20101210000035 DC Practitioner - Emergency Medicine 4284680935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Acute Care Services Alexandria LLCGroup PAC ID 3971993312, 4 clinicians

Practice addresses (Care Compare)

3481 N Beauregard St
Alexandria, VA 22302-1341
Phone (571) 290-3614

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0043690MDMDEmergency Medicine Physician
D43690MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Acute Care Services Alexandria LLC CurrentSince Oct 20, 2022 Accepting new patients
Mid-Atlantic Critical Care Services,L.L.C. PastSince Mar 1, 2013 Accepting new patients
Delphi Healthcare Partners of Maryland LLC Past Accepting new patients

Locations

3481 N Beauregard St
Alexandria, VA 22302
Phone (571) 290-3614

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1336149632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 MARLBORO PIKE",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207472841",
            "telephone_number": "301-736-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 GOOD LUCK RD",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063574",
            "telephone_number": "301-552-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMMA",
        "first_name": "MOUSTAFA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0043690",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D43690",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D43690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.