Shihab Al-Deen Mustafa

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

550 Pope Ave NW Ste 200
Winter Haven, FL 33881-4679

Phone

(863) 299-2630

NPI assigned

Jan 12, 2023

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 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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovacare Florida Urgent Care, LLCGroup PAC ID 1557802840, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shihab.al-deen.mustafa.1@27472.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.

• Innovacare Florida Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wellington, FL
  • NPI 1902507080
  Medicare reassignment Care Compare group
• Trinity Medical Physicians, LLC

  • Family Medicine Physician
  • Lakeland, FL
  • NPI 1225652878
  Medicare reassignment NPD
• Docs Hotline Inc

  • Health Service Clinic/Center
  • Seffner, FL
  • NPI 1891511010
  NPD Authorized official
• Doctors Urgent Care of Lutz LLC

  • Urgent Care Clinic/Center
  • Lutz, FL
  • NPI 1417466525
  Medicare reassignment

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1467166512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "321-343-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE NW STE 200",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814679",
            "telephone_number": "863-299-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Dakota Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Seffner",
            "state": "FL",
            "postal_code": "335845028",
            "country_code": "US",
            "telephone_number": "813-802-3964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "SHIHAB AL-DEEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-12",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Murken, OTR/L
• Michele Murphy
• Katherine Elizabeth Murray, D.C.
• Kevin R Murtagh, M.D.
• Muhammad Mustafa, M.D.
• William Patrick Myers, MD
• Myeyedr. Optometry of Florida, LLC
• Dominique L Myles, RN
• Marie Claire Nagib, DMD
• Ganesh KV Nair, M.D.

• Physician Assistant in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.