DR. MUSTAPHA AHMAD EZZEDDINE (M.D.) – Neurology Physician, NPI 1972534667
Neurology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
640 NEUROLOGY in MN
Provider Addresses for DR. MUSTAPHA AHMAD EZZEDDINE (M.D.)
516 Delaware St SE
PWB Clinc 1A
Minneapolis, MN 554550356
Phone: (612) 625-9900
Fax: (612) 625-7950
Type: Location
Medical Center Boulevard, Ardmore, Winston-Salem, Forsyth County, North Carolina, 27157, United States
WINSTON SALEM, NC 271570356
Phone: (336) 716-2255
Type: Location
Mayo Memorial Building, 420, Southeast Delaware Street, Minneapolis, Hennepin County, Minnesota, 55455, United States
MMC 295
MINNEAPOLIS, MN 554550341
Phone: (612) 625-9900
Fax: (612) 625-7950
Type: Mailing
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: 2019-12-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191216002752 | I | Neurology | NC | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 51 | 32 | $0 |
| 99291 | Critical care, first 30-74 minutes | 44 | 26 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 27 | 27 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 18 | 13 | $0 |
Insurance plans in this area (ZIP 55455)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NC | |
| H E M A T O L O G Y/ O N C O L O G Y | PA | |
| - | NC | |
| P O D I A T R Y | NC | |
| - | NC | |
| A N E S T H E S I O L O G Y | MI | |
| - | NC | |
| H O S P I T A L I S T | NC | |
| Orthopedic Surgery | TX | |
| Physician Assistant | NC |
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