Individual provider Active NPI

Joseph Moussa, MD

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1619483245
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME155089 Issued in FL
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
114487500MedicaidFL

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
I20220616003013 FL Practitioner - Internal Medicine 6709123839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

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

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients
Optumcare Florida, LLC CurrentSince Jul 18, 2022 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.