Active NPI
Joseph Moussa, MD
- Internal Medicine Physician
- Sarasota, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME155089
- Practice address
- 2415 University Pkwy Ste 112
Sarasota, FL 34243-2809 - Phone
- (941) 210-4570
- Fax
- (941) 210-4570
- NPI assigned
- Dec 19, 2017
- Last updated
- Jun 14, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Internal Medicine Physician | 207R00000X | 308632 | NY | |
| Internal Medicine Physician | 207R00000X | ME155089 | FL | Primary |
Addresses
Primary practice location
2415 University Pkwy Ste 112
Sarasota, FL 34243-2809
Mailing address
5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327
Phone (941) 210-4570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114487500 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Cora Health Services Inc
Practice addresses (Care Compare)
11661 State Rd 70
Lakewood Ranch, FL 34202-9416
Phone (941) 222-0321
2415 University Pkwy
Suite 112
Sarasota, FL 34243-2809
Phone (941) 210-4570
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optumcare Florida LLC | Internal Medicine | Current | Accepting new patients |
| Optumcare Florida, LLC | Current | Accepting new patients | |
| Optumcare Florida Ci, LLC | Past | Accepting new patients |
Locations
1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111
1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895
2415 University Pkwy
Ste 112
Sarasota, FL 34243
Phone (941) 210-4570
5130 Sunforest Dr
Ste 300
Tampa, FL 33634
Phone (813) 302-5835
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- joseph.moussa@wellmed.eclinicaldirectplus.com
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.
-
dba Optum
- General Practice Physician
- Tampa, FL
- NPI 1053384214
Internal Medicine
-
- Primary Care Clinic/Center
- Winter Park, FL
- NPI 1720506603
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sarasota Memorial Hospital
- General Acute Care Hospital
- Sarasota, FL
- NPI 1245294826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1619483245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5130 SUNFOREST DR STE 300",
"city": "TAMPA",
"state": "FL",
"postal_code": "336346327",
"telephone_number": "941-210-4570",
"fax_number": "941-210-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 UNIVERSITY PKWY STE 112",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342432809",
"telephone_number": "941-210-4570",
"fax_number": "941-210-4570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSSA",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-19",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "308632",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME155089",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114487500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.