Diana Nasser Mustafa, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9115124 Issued in FL

Practice address

1707 W Reynolds St
Plant City, FL 33563-4737

Phone

(813) 756-5695

NPI assigned

May 5, 2022

Sex

Female

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 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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: diana.mustafa.1@15284.direct.athenahealth.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.

• Omar Aref MD PLC

  • Family Medicine Physician
  • Plant City, FL
  • NPI 1063682540
  Medicare reassignment

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1427794247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 FLORESTA ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116530",
            "telephone_number": "813-545-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W REYNOLDS ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634737",
            "telephone_number": "813-756-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "DIANA",
        "middle_name": "NASSER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9115124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HF MA",
            "identifier": "PI885",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114798100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Mundin, APRN
• David W Murray, MD
• Aziza Musa
• Musculoskeletal Institute Chartered
• Noelle Musella, APRN, RN
• Kelsey Myers
• Patrick Joseph Myers
• Myeyedr. Optometry of Florida, LLC (MyEyeDr.)
• Thaung Han Myint, MD
• Laura Catherine Nall, MD

• Physician Assistant in Plant City, FL
• Providers in Plant City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.