Individual provider Active NPI

Manal Emad Moustafa, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Memphis, TN
National Provider Identifier
1467780684
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
61549 Issued in TN
Practice address
262 Danny Thomas PL
Memphis, TN 38105-3678
Phone
(901) 595-3300
NPI assigned
Nov 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 38838 SC
Pediatrics Physician 208000000X MT195657 PA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 61549 TN Primary

Addresses

Primary practice location

262 Danny Thomas PL
Memphis, TN 38105-3678

Mailing address

262 Danny Thomas PL # Ms 515
Memphis, TN 38105-3678
Phone (901) 595-3300

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CO, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210504001407 TN Practitioner - Neurology 7618278011 Reassigns benefits to 1 organization
I20250417001245 CO Practitioner - Neurology 7618278011 Reassigns benefits to 1 organization
I20260427002449 FL Practitioner - Neurology 7618278011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Tennessee, HSC, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT195657PAMDPediatrics Physician
38838SCMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Colorado P C Pediatrics CurrentSince Apr 1, 2025 Accepting new patients
St Jude Children'S Research Hospital, Inc. Pediatrics CurrentSince Jan 29, 2021 Accepting new patients
Obstetrix Medical Group of Colorado P C CurrentSince Apr 1, 2025 Accepting new patients

Locations

1719 E 19th Ave
Denver, CO 80218
Phone (303) 839-6000

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006

Interoperability endpoints

  • Direct secure messaging: mmoustafa21496@stjude.direct-ci.com

Organizations & group practices 4

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": "1259452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1467780684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL # MS 515",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258908",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSTAFA",
        "first_name": "MANAL",
        "middle_name": "EMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-29",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "SC",
            "license": "38838",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT195657",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TN",
            "license": "61549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.