Individual provider Active NPI

Federico Ivor Mosquera, MD, LSA

  • Surgery Physician
  • Tomball, TX
National Provider Identifier
1861510315
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
SA00134 Issued in TX
Practice address
17307 Elverson Oaks Dr
Tomball, TX 77377-1260
Phone
(832) 493-3204
NPI assigned
Mar 26, 2007
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X SA00134 TX Primary

Addresses

Primary practice location

17307 Elverson Oaks Dr
Tomball, TX 77377-1260

Mailing address

PO Box 690171
Houston, TX 77269-0171
Phone (832) 493-3204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
SA00134TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomball Surgical Assistant Service LLC Surgery CurrentSince Jul 5, 2020 Accepting new patients
Houston Surgical Assistant Services Surgery Past Accepting new patients
Houston Surgical Assistant Services, Inc. Surgery Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1861510315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690171",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772690171",
            "telephone_number": "832-493-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17307 ELVERSON OAKS DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773771260",
            "telephone_number": "832-493-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUERA",
        "first_name": "FEDERICO",
        "middle_name": "IVOR",
        "credential": "MD, LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "SA00134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.