Individual provider Active NPI

Muhammad R Mustafa, MD

  • Nephrology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1952567513
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
268720 Issued in FL
Practice address
1625 SE 3Rd Ave Ste 721
Fort Lauderdale, FL 33316-2521
Phone
(954) 831-7263
Fax
(954) 712-3970
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 268720 FL Primary

Addresses

Primary practice location

1625 SE 3Rd Ave Ste 721
Fort Lauderdale, FL 33316-2521

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 831-2763

Other identifiers 4

IdentifierTypeStateIssuer
ME146665OtherFLFLORIDA MEDICAL LICENSE
MZ748OtherFLMEDICARE ID
278103OtherNYNYS MEDICAL LICENSE
3810012858MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151111000705 NY Practitioner - Internal Medicine 0042386419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Center Advanced Physician Services PCGroup PAC ID 3173660776, 879 clinicians

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530

257 Lafayette Ave
Suite 200
Suffern, NY 10901-4837
Phone (914) 449-3218

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268720FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jul 15, 2016 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jul 15, 2016 Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • Direct secure messaging: mmustafa2022625@direct.trinity-health.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1952567513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-831-2763",
            "fax_number": "954-712-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE STE 721",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-831-7263",
            "fax_number": "954-712-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "MUHAMMAD",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "268720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME146665",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "MZ748",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS MEDICAL LICENSE",
            "identifier": "278103",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012858",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.