Individual provider Active NPI

Amgad Mohamed Abdelhady Moussa, MD

  • Vascular & Interventional Radiology Physician
  • New York, NY
National Provider Identifier
1972165900
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
302116 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2190
NPI assigned
Jun 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 302116 NY Primary
Diagnostic Radiology Physician 2085R0202X MTL-2025-025 GU
Diagnostic Radiology Physician 2085R0202X M-2526 GU

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

303 E 60TH St Apt 24F
New York, NY 10022-1523
Phone (646) 409-7709

Other practice location 1

395 W 12th Ave
Columbus, OH 43210-1267
Phone (614) 293-8315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GU, OH3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200226000423 NY Practitioner - Interventional Radiology 0547697807 Reassigns benefits to 6 organizations
I20260206000398 GU Practitioner - Diagnostic Radiology 0547697807 Reassigns benefits to 2 organizations
I20260220002159 OH Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0547697807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Guam Healthcare Development IncorporatedGroup PAC ID 9234351776, 211 clinicians
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians
Guam Memorial HospitalGroup PAC ID 5890781694, 132 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315

460 Andes Rd
Delhi, NY 13753-7407
Phone (607) 746-0300

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3128
Phone (671) 647-2552

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
  • Guam Regional Medical City Hospital, Dededo, GU, CCN 650003
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085
  • Cobleskill Regional Hospital Hospital, Cobleskill, NY, CCN 331320

Merit-based Incentive Payment System (MIPS)

Final score
65.9 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-2526GUMDDiagnostic Radiology Physician
MTL-2025-025GUMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince Jan 16, 2026 Accepting new patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Jan 24, 2026 Accepting new patients
Guam Memorial Hospital CurrentSince Jan 16, 2026 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Apr 14, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Apr 14, 2025 Accepting new patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

130 North St
Walton, NY 13856
Phone (607) 865-6541

395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299

395 W 12th Ave
Columbus, OH 43210
Phone (614) 293-8299

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: amoussa23636@mskcc.direct-ci.com

Organizations & group practices 10

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 6

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": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1972165900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E 60TH ST APT 24F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221523",
            "telephone_number": "646-409-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-8315",
            "fax_number": "614-293-6935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSSA",
        "first_name": "AMGAD",
        "middle_name": "MOHAMED ABDELHADY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-29",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "302116",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GU",
            "license": "MTL-2025-025",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GU",
            "license": "M-2526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.