Individual provider Active NPI

Sosan L. Moussa, M.D.

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1902866189
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
27593 Issued in AZ
Practice address
1628 N Alvernon Way
Tucson, AZ 85712-3321
Phone
(520) 325-8000
Fax
(520) 325-8616
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 27593 AZ
Pediatrics Physician 208000000X 27593 AZ Primary

Addresses

Primary practice location

1628 N Alvernon Way
Tucson, AZ 85712-3321

Mailing address

4801 E Broadway Blvd Ste 251
Tucson, AZ 85711-2700
Phone (520) 327-0460

Other practice location 1

3085 N Swan Rd
Tucson, AZ 85712-1259
Phone (520) 323-3099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051031000380 AZ Practitioner - Pediatric Medicine 3870510787 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27593AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physician PC CurrentSince Jul 1, 2024 Accepting new patients
Arizona Community Physicians PC Pediatrics CurrentSince Jun 23, 2024 Accepting new patients
Northwest Hospital LLC Pediatrics Past Accepting new patients
Catalina Pediatrics, PC Pediatrics Past Accepting new patients

Locations

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

1628 N Alvernon Way
Tucson, AZ 85712
Phone (520) 321-3566

Interoperability endpoints

  • Direct secure messaging: smoussa21105@azacp.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1902866189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 E BROADWAY BLVD STE 251",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112700",
            "telephone_number": "520-327-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 N ALVERNON WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123321",
            "telephone_number": "520-325-8000",
            "fax_number": "520-325-8616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3085 N Swan Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857121259",
            "country_code": "US",
            "telephone_number": "520-323-3099",
            "fax_number": "520-323-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSSA",
        "first_name": "SOSAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "AZ",
            "license": "27593",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "27593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.