Michael M Moussouttas, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

C1-0012292 Issued in DE

Practice address

4755 Ogletown Stanton Rd Ste 2E99
Newark, DE 19718-2559

Phone

(302) 733-5982

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ, PA, RI, NH, VT, ME, FL, MA, OH, VA, NM, MI12 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 12

Specialty

Neurology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EJFEBD
• Direct secure messaging: mmoussouttas@direct.carene.org

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.

• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  FL, MA, ME, MI, Neurology, NH, NJ, NM, OH, PA, RI, VA, VT

  Medicare reassignment Care Compare group NPD
• Caring Neurology LLC

  • Neurology Physician
  • Freehold, NJ
  • NPI 1427547199
  Medicare reassignment NPD
• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology (Internal Medicine) Physician
  • New Brunswick, NJ
  • NPI 1679655781
  Medicare reassignment NPD
• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662

  Neurology

  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Psychiatry Physician
  • Piscataway, NJ
  • NPI 1033207378
  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Gynecology Physician
  • New Brunswick, NJ
  • NPI 1083779615
  NPD
• Community Hospital Group, Inc

  • Specialist
  • Edison, NJ
  • NPI 1427278258
  NPD (past)
• Community Hospital Group, Inc

  • Cardiovascular Disease Physician
  • Edison, NJ
  • NPI 1467670224
  NPD (past)
• Neurology Associates of Westchester PLLC

  • Neurology Physician
  • Hawthorne, NY
  • NPI 1376624239
  NPD (past)
• Trustees of Columbia University in the City of New York

  • Neurology Physician
  • New York, NY
  • NPI 1306899455
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912907197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 2E99",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "856-630-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 2E99",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182559",
            "telephone_number": "302-733-5982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163352559",
            "country_code": "US",
            "telephone_number": "814-333-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSSOUTTAS",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "PA",
            "license": "MD432784",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "201294",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA07658800",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "NJ",
            "license": "NCC00372-08",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "PA",
            "license": "NCC00372-08",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NJ",
            "license": "25MA07658800",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD432784",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "DE",
            "license": "C1-0012292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018727880005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2095572",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mona Moshet
• Anthony John Mott, DPM
• Natalie Motylinski
• Saida Mouotassim Elidrissi
• Larisa Kavetsky Mouravieff
• Alexia Moutsatsos, MD
• Donna Mower-Wade, CNS
• Robyn Lynn Mowery, PH.D., LMFT
• Maksudul Mowla, PHARMD, RPH
• Moxie Living Counseling & Coaching LLC

• Neurology Physician in Newark, DE
• Providers in Newark, DE by specialty
• Neurology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.