Individual provider Active NPI

Maysoon Mahmud Musbah, RN, FNP-BC

  • Family Nurse Practitioner
  • Elk Grove, CA
National Provider Identifier
1730963380
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95026379 Issued in CA
Practice address
9045 Bruceville Rd
Elk Grove, CA 95758-5948
Phone
(916) 479-9110
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 95026379 CA Primary

Addresses

Primary practice location

9045 Bruceville Rd
Elk Grove, CA 95758-5948

Mailing address

9045 Bruceville Rd
Elk Grove, CA 95758-5948
Phone (916) 479-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229000970 CA Practitioner - Nurse Practitioner 4880039841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elk Grove Urgent Care IncGroup PAC ID 0648340976, 15 clinicians

Practice addresses (Care Compare)

9045 Bruceville Rd
Suite 100
Elk Grove, CA 95758-5950
Phone (916) 479-9110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95026379CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elk Grove Urgent Care Inc Single Specialty CurrentSince Dec 10, 2023 Accepting new patients

Locations

9045 Bruceville Rd
Elk Grove, CA 95758
Phone (916) 479-9110

9045 Bruceville Rd
Ste 100
Elk Grove, CA 95758
Phone (916) 479-9110

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": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1730963380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 BRUCEVILLE RD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585948",
            "telephone_number": "916-479-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 BRUCEVILLE RD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585948",
            "telephone_number": "916-479-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSBAH",
        "first_name": "MAYSOON",
        "middle_name": "MAHMUD",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.