DR. MICHAEL M MOUSSOUTTAS MD NPI 1912907197

NPI Information

NPI: 1912907197
Provider Name: DR. MICHAEL M MOUSSOUTTAS, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
4755 OGLETOWN STANTON RD STE 2E99
NEWARK, DE
ZIP 19718
Phone: (302) 733-5982
Get Directions

DR. Michael M Moussouttas, MD is a neurology psychiatry neurology in Newark, DE. The provider is 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. DR. Michael M Moussouttas, MD NPI is 1912907197. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4755 OGLETOWN STANTON RD STE 2E99
NEWARK, DE
ZIP 19718-559
Phone: (302) 733-5982

The NPI 1912907197 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/28/2005 and was last updated on 10/11/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	C1-0012292	DELAWARE	Yes
2	2084N0400X	Psychiatry & Neurology	Neurology	MD432784	PENNSYLVANIA	No
3	2084N0400X	Psychiatry & Neurology	Neurology	25MA07658800	NEW JERSEY	No
4	2084N0400X	Psychiatry & Neurology	Neurology	201294	NEW YORK	No
5	2084V0102X	Psychiatry & Neurology	Vascular Neurology	25MA07658800	NEW JERSEY	No
6	2084V0102X	Psychiatry & Neurology	Vascular Neurology	MD432784	PENNSYLVANIA	No
7	2084A2900X	Psychiatry & Neurology	Neurocritical Care	NCC00372-08	PENNSYLVANIA	No
8	2084A2900X	Psychiatry & Neurology	Neurocritical Care	NCC00372-08	NEW JERSEY	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	118233PAG	MEDICARE PIN	PENNSYLVANIA
2	0018727880005	MEDICAID	PENNSYLVANIA
3	H21872	MEDICARE UPIN
4	2095572	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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