Mustafa Kaisi

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD15464 Issued in RI

Practice address

164 Summit Ave
Providence, RI 02906-2853

Phone

(401) 793-2104

Fax

(401) 793-4047

NPI assigned

Feb 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

San Diego Critical Care Medical Group IncGroup PAC ID 7911083886, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
• Villa Coronado D/P SNF Nursing home, Coronado, CA, CCN 055074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment Care Compare group NPD
• San Diego Critical Care Medical Group, Inc

  • Internal Medicine Physician
  • El Cajon, CA
  • NPI 1609915990
  Medicare reassignment Care Compare group NPD

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Sharp Coronado Hospital and Healthcare Center

  • General Acute Care Hospital
  • Coronado, CA
  • NPI 1154304475
  Care Compare affiliation
• Sharp Coronado Hospital and Healthcare Center

  • Skilled Nursing Facility
  • Coronado, CA
  • NPI 1184607418

  Nursing home

  Care Compare affiliation
• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1457742934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-2104",
            "fax_number": "401-793-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-2104",
            "fax_number": "401-793-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISI",
        "first_name": "MUSTAFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-05",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD15464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Byron Kahr, LICSW MSW
• Aaron Kaiser, PH.D.
• Melissa Kaiser, PA-C
• Theodore Stanton Kaiser III, RN, CDOE
• Theodore Stanton Kaiser IV
• Pamela Kaitin-Miller, MSW
• Nicholas James Kakos, MD
• Jerome Kalifa, MD
• Loree K Kalliainen, MD
• Markos Kalligeros, MD

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.