Individual provider Active NPI

Daniel Moussa

  • Obstetrics & Gynecology Physician
  • Southgate, MI
National Provider Identifier
1801479696
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301513702 Issued in MI
Practice address
15675 Northline Rd
Southgate, MI 48195-2334
Phone
(734) 282-3600
Fax
(734) 282-3603
NPI assigned
Apr 30, 2021
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301513702 MI Primary

Addresses

Primary practice location

15675 Northline Rd
Southgate, MI 48195-2334

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

4201 Saint Antoine St # 9C
Detroit, MI 48201-2153
Phone (313) 745-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250702004003 MI Practitioner - Obstetrics/Gynecology 7719381714 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians

Practice addresses (Care Compare)

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 284-2400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301513702MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Wyandotte Hospital Obstetrics & Gynecology CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Macomb Hospital Corporation Obstetrics & Gynecology CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Health System Obstetrics & Gynecology CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

51221 Schoenherr Rd
Ste 201
Shelby Township, MI 48315
Phone (586) 254-3545

15675 Northline Rd
Southgate, MI 48195
Phone (734) 282-3600

6773 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 661-6100

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Organizations & group practices 11

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

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1801479696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15675 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952334",
            "telephone_number": "734-282-3600",
            "fax_number": "734-282-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St # 9C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSSA",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301513702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.