Abdelmoniem Moustafa, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

82055 Issued in MN

Practice address

164 Summit Ave
Providence, RI 02906-2853

Phone

(401) 793-4489

NPI assigned

Jul 17, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI, OH, AR, MN4 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 4

Specialty

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mthompson675264@direct.saint-lukes.org

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• Adena Medical Group LLC

  • Family Medicine Physician
  • Chillicothe, OH
  • NPI 1235468083

  Internal Medicine

  Medicare reassignment NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665
  Medicare reassignment
• Centracare Health System-NR LLC

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  Medicare reassignment
• Centracare Health System-NR LLC

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1558600874
  Medicare reassignment
• Crossett Health Foundation

  • Critical Access Hospital
  • Crossett, AR
  • NPI 1952308215
  Medicare reassignment
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781395200000",
    "number": "1477937696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "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": "401-793-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAFA",
        "first_name": "ABDELMONIEM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-17",
        "last_updated": "2026-06-14",
        "certification_date": "2026-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MN",
            "license": "82055",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Mounier
• Jack Mountain, PHARMD
• Abdul Rahman Mourad, M.D.
• Andre Jiorjios Moussa Kassis, MD
• Khadija Joy Moussadek, MD
• Farah Moustafa, MD
• Victoria Moutahir, LMT
• Tegan Regina Mouw
• Kiarra Elizabeth Mouzon, MD
• Elaine Ellen Mowry, P.T.

• Clinical Cardiac Electrophysiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Cardiac Electrophysiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2026; 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.