Individual provider Active NPI

Justice Mushonga

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1821451147
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301109622 Issued in MI
Practice address
2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Phone
(313) 916-2600
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME151318 FL
Anesthesiology Physician 207L00000X 4301109622 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Phone (313) 916-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 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
I20210827000850 FL Practitioner - Anesthesiology 1355635517 Reassigns benefits to 2 organizations
I20230503002578 CA Practitioner - Anesthesiology 1355635517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf-to-Bay Anesthesiology Associates LLCGroup PAC ID 5092628156, 330 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Anesthesia Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Jan 15, 2024 Accepting new patients
Sunshine State Anesthesia Partners LLC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Jan 15, 2024 Accepting new patients

Locations

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

10740 Palm River Rd
Ste 200
Tampa, FL 33619
Phone (813) 660-6000

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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.

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1821451147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSHONGA",
        "first_name": "JUSTICE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME151318",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301109622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.