DR. MICHAEL M MOUSSOUTTAS (NPI# 1912907197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912907197 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL M MOUSSOUTTAS |
| Credential | MD |
| Practice Address |
4755 Ogletown Stanton Rd Ste 2e99 Newark DE 19718-2559 |
| Mailing Address |
4755 Ogletown Stanton Rd Ste 2e99 Newark DE 19718-2200 |
| Practice Telephone | 3027335982 |
| Mailing Telephone | 8566302406 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2017-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
C1-0012292 | DE | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD432784 | PA | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
201294 | NY | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
25MA07658800 | NJ | Allopathic & Osteopathic Physicians |
| N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
MD432784 | PA | Allopathic & Osteopathic Physicians |
| N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
25MA076588 | NJ | Allopathic & Osteopathic Physicians |
| N | 2084A2900X |
Psychiatry & Neurology Specialization: Neurocritical Care |
NCC00372-08 | PA | Allopathic & Osteopathic Physicians |
| N | 2084A2900X |
Psychiatry & Neurology Specialization: Neurocritical Care |
NCC00372-0 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0018727880005 | 05 | |
| NJ | 2095572 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 751 Liberty St, Meadville, PA 163352559 | 8143335000 |
| Street Address |
4755 OGLETOWN STANTON RD STE 2E99 |
| City | NEWARK |
| State | DE |
| Zip Code | 19718-2559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412661 | Jason A Macdonald | Registered Nurse | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2020-09-18 |
| 1437612876 | Amanda Elizabeth Williams | Registered Nurse | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2049 | 2019-04-11 |
| 1790260115 | Sarah Marie Pingar | Physician Assistant | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2018-10-02 |
| 1477060564 | Jodi Kahan | Nurse Practitioner | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718 | 2018-01-10 |
| 1891200424 | Jamie Feinour | Nurse Practitioner | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2017-12-05 |
| 1205340049 | Rebecca L Avello | Physician Assistant | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2017-11-30 |
| 1528598257 | John W Sammon | Nurse Practitioner | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2017-06-15 |
| 1730519372 | Shanna Marie Amoroso | Registered Nurse | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2013-11-18 |
| 1750714283 | Jenna Heaney | Registered Nurse | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-2200 | 2013-08-20 |
| 1912345950 | Hersh Patel | Anesthesiology | 4755 Ogletown Stanton Rd Ste 2e99, Newark, DE 19718-6402 | 2013-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679026272 | Vikashsingh Parshin Rambhujun | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Road, Suite 2875, Newark, DE 19718 | 2016-07-29 |
| 1730536053 | David Nathan Levine | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, Christiana Health Care, Newark, DE 19718 | 2016-05-17 |
| 1831570332 | Waqas Abid | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, S-le45, Newark, DE 19718 | 2015-06-11 |
| 1366886368 | Amanda J Taylor | Family Medicine | 4755 Ogletown Stanton Rd Ste 6e34, Newark, DE 19718 | 2013-04-20 |
| 1114360872 | Kalpana Suresh | Surgery | 4755 Ogletown-stanton Rd., Newark, DE 19718 | 2013-04-12 |
| 1568580769 | Ember L. Crevar | Pediatrics | 4755 Ogletown Stanton Rd., Christiana Care Hospital - Dept. of Pediatrics, Newark, DE 19718 | 2007-03-26 |
| 1336283803 | Kevin William Smallwood | Physician Assistant | 4755 Ogletown-stanton Dr, Suite 1e50, Newark, DE 19718 | 2007-02-17 |
| 1023066404 | Samuel G Putnam IIi | Radiology | 4755 Ogletown Santon Road, Suite 1e20, Newark, DE 19718 | 2006-05-05 |
| 1053374181 | Hung Quang Dam | Nuclear Medicine | Nuclear Medicine, 4755 Ogletown-stanton Rd, Newark, DE 19718 | 2006-04-10 |
| 1346211018 | Robert Flinn | Internal Medicine | 4655 Ogletown-stanton Road, Suite 5343, Newark, DE 19718 | 2006-01-30 |
| Find all providers in zip 19718 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164994166 | Acclaim Neurodiagnostics Group | Psychiatry & Neurology | 537 Stanton Christiana Rd Ste 106, Newark, DE 19713-2145 | 2019-01-02 |
| 1639300676 | Delaware Neuroscience Specialists | Psychiatry & Neurology | 774 Christiana Rd Ste 201b, Newark, DE 19713-4221 | 2009-08-06 |
| 1841461019 | Deren Huang | Psychiatry & Neurology | 150 Mcmillon Drive, Newark, OH 43055 | 2008-03-17 |
| 1477754893 | Maria R Alvarez Prieto | Psychiatry & Neurology | 41 Wilson Ave, Suite 2d, Newark, NJ 07105 | 2007-05-31 |
| 1245257013 | Eugene A Tolomeo | Psychiatry & Neurology | 1312 Driving Park Ave, Newark, NY 14513-1059 | 2006-07-16 |
| 1932131265 | John Robert Pollard | Psychiatry & Neurology | 774 Christiana Road, Suite 201, Newark, DE 19713-4221 | 2006-07-07 |
| 1902858475 | Joseph Handler | Psychiatry & Neurology | 774 Christiana Rd Ste 201, Newark, DE 19713-4221 | 2006-05-16 |
| 1518317973 | Garland Tang | Psychiatry & Neurology | 150 Mcmillen Dr, Newark, OH 43055-1811 | 2016-06-16 |
| 1356756142 | Sandeep Devarapalli | Psychiatry & Neurology | 200 Hygeia Dr, Newark, DE 19713-2049 | 2014-07-01 |
| 1801206743 | Douglas B. Gersh, Md., LLC | Psychiatry & Neurology | 774 Christiana Rd, Suite 201, Newark, DE 19713-4236 | 2014-04-30 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.