Mesum Moosavi, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25MA10937100 Issued in NJ

Practice address

290 Lafayette Ave
Hawthorne, NJ 07506-1961

Phone

(856) 266-0445

NPI assigned

Jul 1, 2013

Reactivated

Dec 13, 2017

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 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

Specialty

Geriatric Medicine

Education

George Washington University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medassist NJ IIGroup PAC ID 1557717428, 23 clinicians

Wound Healing Associates PCGroup PAC ID 2668789116, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

20.98 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

69.93

Merit-based Incentive Payment System (MIPS)

Final score

25.04 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

83.45

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Medassist NJ II

  • Geriatric Medicine (Family Medicine) Physician
  • Lakewood, NJ
  • NPI 1336928407

  NY, Single Specialty

  Medicare reassignment Care Compare group NPD
• Wound Healing Associates PC

  • Internal Medicine Physician
  • Hawthorne, NJ
  • NPI 1932585445

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Temple University Hospital

  • General Acute Care Hospital
  • Lumberton, NJ
  • NPI 1134533052
  Authorized official Same address or phone
• Medassist USA LLC

  • Case Management Agency
  • Lakewood, NJ
  • NPI 1982211439

  Single Specialty

  NPD
• Medequipped LLC

  • Customized Equipment (DME)
  • Spring Valley, NY
  • NPI 1619489044
  NPD
• Express Medical Wellness LLC

  • Physician Assistant
  • Cambridge, MD
  • NPI 1437830759

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1841630191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 MORRIS TPKE FL 4",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 LAFAYETTE AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075061961",
            "telephone_number": "856-266-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSAVI",
        "first_name": "MESUM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "deactivation_date": "2017-10-18",
        "reactivation_date": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "R73958",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA10937100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa D. Minnema, PT
• Mitesh R Patel DDS LLC (Hawthorne Family Dentistry)
• Julianna Marie Mola, OD
• Effie Molina
• Young Sun Moon, L.AC.
• Abdulmasih Munirji, PHARMACIST
• Daryl Murphy, PT
• Sarah Murray, M.A. CCC-SLP
• Sabiha Nasir, RPH
• Paul R Nekich, PTA

• General Practice Physician in Hawthorne, NJ
• Providers in Hawthorne, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.