Individual provider Active NPI

Raed Mousa, MD

  • Retina Specialist (Ophthalmology) Physician
  • Erie, PA
National Provider Identifier
1639913403
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
MD487376 Issued in PA
Practice address
300 State St Ste 201
Erie, PA 16507-1429
Phone
(814) 456-4241
NPI assigned
Jun 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X MD487376 PA Primary

Addresses

Primary practice location

300 State St Ste 201
Erie, PA 16507-1429

Mailing address

1416 Drake Dr
Erie, PA 16505-2604
Phone (814) 582-6160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241122002157 PA Practitioner - Ophthalmology 5294260550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Retinal Surgery, Inc.Group PAC ID 0941286595, 9 clinicians

Practice addresses (Care Compare)

300 State St
Erie, PA 16507-1427
Phone (814) 456-4241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD487376PAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Retinal Surgery, Inc. CurrentSince Nov 11, 2024 Accepting new patients

Locations

300 State St
Ste 200A
Erie, PA 16507
Phone (814) 456-4241

300 State St
Erie, PA 16507
Phone (814) 453-4575

300 State St
Ste 201
Erie, PA 16507
Phone (814) 456-4241

Interoperability endpoints

  • Direct secure messaging: rmousa@erieretinal.intellechartdirect.net

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1639913403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 DRAKE DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052604",
            "telephone_number": "814-582-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE ST STE 201",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071429",
            "telephone_number": "814-456-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSA",
        "first_name": "RAED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-25",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "PA",
            "license": "MD487376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.