Mostafa Sheta, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7195 Issued in NV

Practice address

282 E. Lake Mead Pkwy
Henderson, NV 89015

Phone

(702) 567-9002

Fax

(702) 567-9003

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1881761385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 S EASTERN AVE",
            "address_2": "STE 150",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525576",
            "telephone_number": "702-567-9002",
            "fax_number": "702-567-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 E. LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89015",
            "telephone_number": "702-567-9002",
            "fax_number": "702-567-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETA",
        "first_name": "MOSTAFA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "7195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019731",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.