Mousa Matar MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MOUSA MATAR MD INC

Practice address

4440 Brockton Ave Ste 100
Riverside, CA 92501-4026

Phone

(773) 814-8200

Fax

(951) 788-6380

NPI assigned

Jul 5, 2022

Organization subpart

Yes

Parent organization

MOUSA MATAR MD INCAs reported in NPPES

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

Authorized official

Name

Mousa Matar, MDNPI 1992116982

Title

MD

Phone

(773) 814-8200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Part of

Mousa Matar MD Inc

Locations

Interoperability endpoints

• Direct secure messaging: mousamatar@mmatar.allscriptsdirect.net

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mousa Matar, M.D.

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1992116982
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1558094904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917851810",
            "telephone_number": "773-814-8200",
            "fax_number": "951-750-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BROCKTON AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014026",
            "telephone_number": "773-814-8200",
            "fax_number": "951-788-6380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Central Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925062930",
            "country_code": "US",
            "telephone_number": "951-788-8332",
            "fax_number": "951-788-6380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUSA MATAR MD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUSA MATAR MD INC",
        "enumeration_date": "2022-07-05",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "MATAR",
        "authorized_official_first_name": "MOUSA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "773-814-8200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gregory Lamond Mourland Jr.
• Zahir Moussa
• Allanah Mouton
• Nick Movsesian
• Lisa Marie Mowery Jones, RGIS
• Angelina Moxey, LMFT

• Internal Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.