Individual provider Active NPI

Noah Hershel Mostkoff, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1548716459
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109752 Issued in FL
Practice address
5 Tampa General Cir Ste 820
Tampa, FL 33606
Phone
(813) 844-3228
NPI assigned
Aug 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA215060 OR
Physician Assistant 363A00000X PA9109752 FL Primary

Addresses

Primary practice location

5 Tampa General Cir Ste 820
Tampa, FL 33606

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (786) 596-2000

Other practice location 2

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (786) 596-2000

Other practice location 3

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038

Other identifiers 2

IdentifierTypeStateIssuer
SMAQGOtherFLBLUE CROSS BLUE SHIELD
023653000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmostkoff209209@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180228000366 FL Practitioner - Physician Assistant 9436410842 Reassigns benefits to 1 organization
I20230406001559 OR Practitioner - Physician Assistant 9436410842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4202 E Fowler Ave
Tampa, FL 33620-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109752FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Legacy Clinics LLC CurrentSince Mar 31, 2023 Accepting new patients
University Medical Service Association Inc Physician Assistant Past Accepting new patients

Locations

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1548716459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TAMPA GENERAL CIR STE 820",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33606",
            "telephone_number": "813-844-3228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 N Kendall Dr",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762118",
            "country_code": "US",
            "telephone_number": "786-596-2000",
            "fax_number": "305-279-7778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8900 N Kendall Dr",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762118",
            "country_code": "US",
            "telephone_number": "786-596-2000",
            "fax_number": "305-279-7778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTKOFF",
        "first_name": "NOAH",
        "middle_name": "HERSHEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA215060",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "SMAQG",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023653000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmostkoff209209@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.