Individual provider Active NPI

Mojdeh Sheila Kappus, MD

  • Surgery Physician
  • Stuart, FL
National Provider Identifier
1366887960
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
160994 Issued in FL
Practice address
3801 S Kanner Hwy Ste 200
Stuart, FL 34994-4801
Phone
(772) 219-4026
Fax
(772) 283-4919
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 298783 NY
Surgery Physician 208600000X 160994 FL Primary

Addresses

Primary practice location

3801 S Kanner Hwy Ste 200
Stuart, FL 34994-4801

Mailing address

3801 S Kanner Hwy Ste 200
Stuart, FL 34994-4801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190828002748 NY Practitioner - General Surgery 5799013728 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of New York at Buffalo School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Niagara Falls Memorial Medical CenterGroup PAC ID 0244134484, shared by 2 NPIs, 67 clinicians

Practice addresses (Care Compare)

620 10TH St
Suite 704
Niagara Falls, NY 14301-1841
Phone (716) 278-4402

621 10TH St
Niagara Falls, NY 14301-1813
Phone (716) 278-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160994FLMDSurgery Physician
298783NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Niagara Falls Memorial Medical Center Surgery CurrentSince Dec 7, 2019 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Dec 7, 2019 Accepting new patients
General Physician, PC CurrentSince Sep 1, 2019 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Dec 7, 2019 Accepting new patients
Lake Erie Medical Services, PC PastSince Jul 28, 2019 Accepting new patients

Locations

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

419 Central Ave
Dunkirk, NY 14048
Phone (716) 952-4266

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

620 10th St
Ste 700
Niagara Falls, NY 14301
Phone (716) 278-0873

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

Organizations & group practices 5

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 1

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1366887960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 S KANNER HWY STE 200",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S KANNER HWY STE 200",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944801",
            "telephone_number": "772-219-4026",
            "fax_number": "772-283-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPPUS",
        "first_name": "MOJDEH",
        "middle_name": "SHEILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "298783",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "160994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.