Active NPI
Nouhad Yacoub Moussa, MD
- Emergency Medicine Physician
- Tampa, FL
National Provider Identifier
1497797807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME68141
- Practice address
- 3301 W Gandy Blvd
Tampa, FL 33611-2931 - Phone
- (813) 925-1903
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME68141 | FL | |
| Emergency Medicine Physician | 207P00000X | ME68141 | FL | Primary |
Addresses
Primary practice location
3301 W Gandy Blvd
Tampa, FL 33611-2931
Mailing address
PO Box 64568
Phoenix, AZ 85082-4568
Phone (318) 424-5449
Other practice location 1
3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 870-4000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26902 | Other | FL | BLUE CROSS OF FLORIDA |
| 101288 | Other | FL | AMERIGROUP |
| 377492900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561334400000",
"number": "1497797807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64568",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850824568",
"telephone_number": "318-424-5449",
"fax_number": "855-230-1466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 W GANDY BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336112931",
"telephone_number": "813-925-1903"
}
],
"practiceLocations": [
{
"address_1": "3001 W Dr Martin Luther King Jr Blvd",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336076307",
"country_code": "US",
"telephone_number": "813-870-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOUSSA",
"first_name": "NOUHAD",
"middle_name": "YACOUB",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-11",
"last_updated": "2019-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME68141",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME68141",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF FLORIDA",
"identifier": "26902",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "101288",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "377492900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.