SHIHAB AL-DEEN MUSTAFA – Physician Assistant, NPI 1467166512

SHIHAB AL-DEEN MUSTAFA is a healthcare provider. based in Seffner, Florida. specializing in PHYSICIAN ASSISTANT. The NPI Number for SHIHAB AL-DEEN MUSTAFA is 1467166512

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
SHIHAB AL-DEEN MUSTAFA
NPI
1467166512
Phone
(813) 802-3964
Address
305 Dakota Hill Dr
Enumeration Date
12 January 2023
Last Update Date
27 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8636447337
Graduation Year
2024 (2 years ago)
PAC ID
3779016696
Group Practice PAC ID
1557802840
Professional Enrollment ID
I20241031000661
Address ID
FL338034574LA3240XAVEX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:3State licenses:0Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for SHIHAB AL-DEEN MUSTAFA

  • 305 Dakota Hill Dr

    Seffner, FL 335845028

    Phone: (813) 802-3964

    Type: Location

  • 425 W COLONIAL DR STE 303

    ORLANDO, FL 328046863

    Phone: (321) 343-6833

    Type: Mailing

  • 550 POPE AVE NW STE 200

    WINTER HAVEN, FL 338814679

    Phone: (863) 299-2630

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241031000661IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33584)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557802840View full group profile
NameSpecialtyState
Physician AssistantFL
Internal MedicineFL
Nurse PractitionerOH
Physician AssistantNV
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantFL
Physician AssistantFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Can I cross-check SHIHAB AL-DEEN MUSTAFA using NPI 1467166512?
NPI 1467166512 belongs to SHIHAB AL-DEEN MUSTAFA; compare other details if you need extra assurance.
Active or inactive — what applies to SHIHAB AL-DEEN MUSTAFA?
You should see SHIHAB AL-DEEN MUSTAFA as active in CMS-hosted NPPES data.
What kind of doctor is SHIHAB AL-DEEN MUSTAFA?
SHIHAB AL-DEEN MUSTAFA is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with SHIHAB AL-DEEN MUSTAFA?
Directory geography for SHIHAB AL-DEEN MUSTAFA centers on Seffner, Florida.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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