DR. ELLIS MOSSADED (M.D.) – General Practice Physician, NPI 1790195261

DR. ELLIS MOSSADED (M.D.) is a healthcare provider. based in Acworth, Georgia. specializing in GENERAL PRACTICE. They hold the professional credentials M.D.. They hold a License No. 74500 (GA). The NPI Number for DR. ELLIS MOSSADED (M.D.) is 1790195261

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
DR. ELLIS MOSSADED (M.D.)
NPI
1790195261
Phone
(770) 975-1299
Address
3889 COBB PKWY NW
Enumeration Date
5 May 2014
Last Update Date
8 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2486601220
Graduation Year
1984 (42 years ago)
PAC ID
1658597695
Group Practice PAC ID
5395098339
Professional Enrollment ID
I20230804003488
Address ID
GA300842903TU4608XHWYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

164 GENERAL PRACTICE in GA

Provider Addresses for DR. ELLIS MOSSADED (M.D.)

  • 3889 COBB PKWY NW

    ACWORTH, GA 301014084

    Phone: (770) 975-1299

    Type: Mailing

  • 6065 ROSWELL RD

    SANDY SPRINGS, GA 303284011

    Phone: (770) 231-3100

    Type: Mailing

  • 2200 OLD HAMILTON PL

    GAINESVILLE, GA 305077892

    Phone: (770) 532-2066

    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: 2023-08-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20140728001062IGeneral PracticeNYTBD
I20230804003488IGeneral PracticeGATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99441Telephone medical discussion with physician, 5-10 minutes2424$0
View full utilization report →

Insurance plans in this area (ZIP 30101)

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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: 5395098339View full group profile
NameSpecialtyState
Family Practice, Emergency MedicineMI
Nurse PractitionerGA
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantMI
Nurse PractitionerTN
Nurse PractitionerOH
Nurse PractitionerNC

Reviews

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Frequently asked questions

Does DR. ELLIS MOSSADED (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. ELLIS MOSSADED (M.D.) uses 1790195261.
Is DR. ELLIS MOSSADED (M.D.) still practicing?
DR. ELLIS MOSSADED (M.D.) is currently listed as active in the public NPI registry.
What is DR. ELLIS MOSSADED (M.D.)'s specialty?
The listing groups DR. ELLIS MOSSADED (M.D.) with General Practice Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. ELLIS MOSSADED (M.D.) on a map?
Expect Acworth, Georgia as a primary anchor for DR. ELLIS MOSSADED (M.D.) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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