NPIMap

Organization Active NPI

Crescent Wound Care Inc

  • Surgery Physician
  • Melbourne, FL
National Provider Identifier
1902749641
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CRESCENT WOUND CARE INC
Practice address
765 W Nasa Blvd
Melbourne, FL 32901-1815
Phone
(321) 733-5725
Fax
(321) 733-5799
NPI assigned
Apr 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Mohamed Kadry-Hassanein, MD
Title
Owner
Phone
(858) 967-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

765 W Nasa Blvd
Melbourne, FL 32901-1815

Mailing address

5580 La Jolla Blvd Ste 622
La Jolla, CA 92037-7651
Phone (858) 221-7726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260504007939 FL Part B Supplier - Clinic/Group Practice 3274914502 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Crescent Wound Care Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1902749641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 LA JOLLA BLVD STE 622",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377651",
            "telephone_number": "858-221-7726",
            "fax_number": "858-431-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 W NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011815",
            "telephone_number": "321-733-5725",
            "fax_number": "321-733-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT WOUND CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "KADRY-HASSANEIN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-967-3070",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.