Individual provider Active NPI

Samar Musmar

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1619371556
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME65237 Issued in FL
Practice address
3128 E Hillsborough Ave
Tampa, FL 33610
Phone
(813) 579-1767
Fax
(813) 305-7907
NPI assigned
Oct 21, 2014
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME65237 FL Primary

Addresses

Primary practice location

3128 E Hillsborough Ave
Tampa, FL 33610

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other practice location 1

1129 N Missouri Ave
Lakeland, FL 33805-4411
Phone (863) 413-8600

Other practice location 2

1129 N Missouri Ave
Lakeland, FL 33805-4411
Phone (863) 413-8600

Other names 1

  • Dr. Samar Ghazal Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150803001373 FL Practitioner - Family Practice 3274847348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3128 E Hillsborough Ave
Chen Central FL Holdings
Tampa, FL 33610-4528
Phone (813) 579-1769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc. CurrentSince May 1, 2015 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 11, 2017 Accepting new patients
Central Florida Health Care, Inc CurrentSince May 1, 2015 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 11, 2017 Accepting new patients

Locations

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

3128 E Hillsborough Ave
Tampa, FL 33610
Phone (813) 579-1767

47 5th St NW
Winter Haven, FL 33881

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1619371556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 E HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "813-579-1767",
            "fax_number": "813-305-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 N Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054411",
            "country_code": "US",
            "telephone_number": "863-413-8600",
            "fax_number": "863-413-8651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1129 N Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054411",
            "country_code": "US",
            "telephone_number": "863-413-8600",
            "fax_number": "863-413-8651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSMAR",
        "first_name": "SAMAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME65237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMAR",
            "last_name": "GHAZAL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.