Individual provider Active NPI

Edim Musa

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1558907311
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
188129 Issued in AZ
Practice address
255 W Brown Rd
Mesa, AZ 85201-3404
Phone
(480) 985-1093
NPI assigned
Nov 26, 2019
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 188129 AZ Primary

Addresses

Primary practice location

255 W Brown Rd
Mesa, AZ 85201-3404

Mailing address

PO Box 20610
Mesa, AZ 85277-0610
Phone (480) 985-1093

Other practice location 1

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5555

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emusa01@my.gcu.edu Direct Banner Thunderbird Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211110002703 AZ Practitioner - Nurse Practitioner 7517356694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leading Healthcare Specialist PLLCGroup PAC ID 6002246352, 20 clinicians

Practice addresses (Care Compare)

12622 E Victoria St
Chandler, AZ 85249-3748
Phone (623) 295-1190

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
188129AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Hospitalist Associates LLC CurrentSince May 27, 2023 Accepting new patients
Leading Healthcare Specialist PLLC CurrentSince Nov 1, 2021 Accepting new patients
Leading Healthcare, LLC Past Accepting new patients

Locations

13555 W McDowell Rd
Ste 205
Goodyear, AZ 85395
Phone (623) 535-0740

255 W Brown Rd
Mesa, AZ 85201
Phone (480) 833-3988

1880 E Van Buren St
Phoenix, AZ 85006
Phone (602) 253-4570

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1558907311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20610",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852770610",
            "telephone_number": "480-985-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013404",
            "telephone_number": "480-985-1093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064622",
            "country_code": "US",
            "telephone_number": "602-865-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSA",
        "first_name": "EDIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "188129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emusa01@my.gcu.edu",
            "affiliation": "Y",
            "affiliationName": "Banner Thunderbird Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5555 W Thunderbird Rd",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853064622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.