MR. IVAN A MUSTAFA (ARNP) – Nurse Practitioner, NPI 1497727804
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
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Provider Addresses for MR. IVAN A MUSTAFA (ARNP)
600, Dixie Avenue, Leesburg, Lake County, Florida, 34748, United States
LEESBURG, FL 347485925
Phone: (352) 323-5762
Type: Location
8490 NE 150TH AVE
WILLISTON, FL 326963842
Phone: (407) 758-4104
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $170.
Total Amount is formed as General ($170) + Research ($0) + Ownership ($0) = $170.
Last reported payment date: 2024-06-18 • Largest payer in this snapshot: Inari Medical, Inc. ($153).
Total Amount
$170
General + Research + Ownership
Payments
2
Total payment records
General Amount
$170
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $153 |
| Lilly USA, LLC | $16 |
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: 2024-09-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20031112000474 | I | Nurse Practitioner | FL | TBD |
| I20220701001531 | I | Nurse Practitioner | MT | TBD |
| I20240911002316 | I | Nurse Practitioner | WY | TBD |
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.
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 34748)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Allergy/Immunology | MT | |
| Physician Assistant | MT | |
| Nurse Practitioner | MT | |
| Physician Assistant | CO | |
| Nurse Practitioner | MT | |
| Physician Assistant | MP | |
| Nurse Practitioner | UT | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | MT | |
| Family Practice | WV |
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