Individual provider Active NPI

Mounir Makram Wassef, D.O.

  • Dermatology Physician
  • Wellington, FL
National Provider Identifier
1659512366
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS10492 Issued in FL
Practice address
12788 Forest Hill Blvd Ste 1004
Wellington, FL 33414-4703
Phone
(561) 246-1791
Fax
(561) 469-6456
NPI assigned
Mar 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS 10492 FL
Dermatology Physician 207N00000X OS10492 FL Primary

Addresses

Primary practice location

12788 Forest Hill Blvd Ste 1004
Wellington, FL 33414-4703

Mailing address

12788 Forest Hill Blvd Ste 1004
Wellington, FL 33414-4703
Phone (561) 246-1791

Other identifiers 1

IdentifierTypeStateIssuer
14JU9OtherFLBLUE CROSS

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
I20141120001125 FL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 2961624267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12788 Forest Hill Blvd
Suite 1004
Wellington, FL 33414-4703
Phone (561) 246-1791

Hospital & facility affiliations

  • HCA Florida Palms West Hospital Hospital, Loxahatchee, FL, CCN 100269

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal54
Melanoma (skin cancer) excision120
Removal of tissue1-10
Removal of skin lesions1267
Removal of skin cancer118
Removal or shaving of skin growth200
Skin biopsy348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS10492FLMDDermatology Physician
OS 10492FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Family Medicine, LLC CurrentSince May 1, 2020 Accepting new patients
Dermatology & Cutaneous Surgery Institute (Dcsi), PA Dermatology CurrentSince Apr 1, 2014 Accepting new patients

Locations

5130 Linton Blvd
Ste C4
Delray Beach, FL 33484
Phone (561) 246-1791

12785 Forest Hill Blvd
Ste 8E
Wellington, FL 33414
Phone (561) 331-5155

12785 Forest Hill Blvd
#8E
Wellington, FL 33414
Phone (561) 246-1791

12788 Forest Hill Blvd
Ste 1004
Wellington, FL 33414
Phone (561) 246-1791

Organizations & group practices 2

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.

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": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1659512366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12788 FOREST HILL BLVD STE 1004",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144703",
            "telephone_number": "561-246-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12788 FOREST HILL BLVD STE 1004",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144703",
            "telephone_number": "561-246-1791",
            "fax_number": "561-469-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSEF",
        "first_name": "MOUNIR",
        "middle_name": "MAKRAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-10",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS 10492",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS10492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "14JU9",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.