Individual provider Active NPI

Mutaz Musa, M.D.

  • Emergency Medicine Physician
  • Carbondale, IL
National Provider Identifier
1720432115
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036150055 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
Fax
(618) 457-0469
NPI assigned
Apr 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036150055 IL Primary
Emergency Medicine Physician 207P00000X 84930 WI

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

Other practice location 2

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Other practice location 3

2116 Craig Rd
Eau Claire, WI 54701-6118
Phone (715) 858-4610

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mmusa27403@sih.direct-ci.com
Direct Messaging Address mmusa27403@sih.direct-ci.com
Direct Messaging Address mmusa27403@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241017000225 WI Practitioner - Emergency Medicine 8527396795 Reassigns benefits to 10 organizations
I20260417003417 FL Practitioner - Emergency Medicine 8527396795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

265 Brookview Centre Way
Knoxville, TN 37919-4052

3349 St Vincent Ter
Lakeland, FL 33812-4099

4100 International PLZ
Fort Worth, TX 76109-4800

Hospital & facility affiliations

  • Marshfield Medical Center - Eau Claire Hospital, Eau Claire, WI, CCN 520210
  • Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84930WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Oct 9, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 9, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 9, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 9, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 9, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 9, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 9, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 9, 2024 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 9, 2024 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
MCHS Hospitals Inc Emergency Medicine Current Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: mmusa27403@sih.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1720432115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721",
            "fax_number": "618-457-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "fax_number": "618-351-4917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016118",
            "country_code": "US",
            "telephone_number": "715-858-4610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSA",
        "first_name": "MUTAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036150055",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "84930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmusa27403@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmusa27403@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmusa27403@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.