Individual provider Active NPI

Gina M. Foster-Moumoutjis, MD

  • Family Medicine Physician
  • Davie, FL
National Provider Identifier
1730347030
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125729 Issued in FL
Practice address
3600 S University Dr
Davie, FL 33328-2709
Phone
(954) 262-1860
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME125729 FL Primary
Family Medicine Physician 207Q00000X 251998-1 NY
Family Medicine Physician 207Q00000X A113319 CA

Addresses

Primary practice location

3600 S University Dr
Davie, FL 33328-2709

Mailing address

3200 S University Dr
Davie, FL 33328-2018
Phone (954) 262-1760

Other identifiers 1

IdentifierTypeStateIssuer
000695941MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://login.intelichart.com/NSUHealthClinics/

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
I20170201002679 FL Practitioner - Family Practice 6103976964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Miami, LM Miller School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

3200 S University Dr
Daive, FL 33328-2018
Phone (954) 262-4343

Merit-based Incentive Payment System (MIPS)

Final score
72.47 of 100Reported as group
Quality
62.45
Improvement activities
40
Cost
73.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251998-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University Inc. CurrentSince Dec 6, 2016 Accepting new patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University, Inc CurrentSince Dec 6, 2016 Accepting new patients
Nova Southeastern University, Inc Family Medicine Past Accepting new patients

Locations

3600 S University Dr
Davie, FL 33328
Phone (540) 422-3321

3200 S University Dr
Fl 3
Davie, FL 33328

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 4

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1730347030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282709",
            "telephone_number": "954-262-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER-MOUMOUTJIS",
        "first_name": "GINA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125729",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "251998-1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A113319",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000695941",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.intelichart.com/NSUHealthClinics/",
            "affiliation": "N",
            "address_1": "3600 S University Dr",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333282709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.