KATRINA L WILLIE-MUSOMA MD NPI 1003023979

Pediatrics in Mansfield, TX

NPI 1003023979 Individual Female Pediatrics PECOS Enrolled

About KATRINA WILLIE-MUSOMA

Katrina Willie-musoma is a pediatrician established in Mansfield, Texas and her medical specialization is pediatrics. The NPI number of Katrina Willie-musoma is 1003023979 and was assigned on May 2007. The practitioner's primary taxonomy code is 208000000X with license number M9742 (TX). The provider is registered as an individual and her NPI record was last updated 4 years ago.

A pediatrician like Katrina L Willie-musoma Md is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Katrina Willie-musoma is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Katrina Willie-musoma is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1003023979

Provider Name KATRINA L WILLIE-MUSOMA MD
Provider Location Address2800 E BROAD ST STE 100 MANSFIELD, TX 76063
Provider Mailing Address2800 E BROAD ST STE 100 MANSFIELD, TX 76063
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-17-2007
Last Update Date03-17-2018


Primary Taxonomy

Taxonomy Code208000000X
ClassificationPediatrics
TypeAllopathic & Osteopathic Physicians
License No.M9742
License StateTX
Taxonomy DescriptionA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Business Address

KATRINA L WILLIE-MUSOMA MD
2800 E BROAD ST STE 100
MANSFIELD, TX
ZIP 76063
Phone:
Fax: (817) 539-0476

Get Directions


Mailing Address

KATRINA L WILLIE-MUSOMA MD
2800 E BROAD ST STE 100
MANSFIELD, TX
ZIP 76063
Phone:
Fax: (817) 539-0476



Secondary Locations

998 Winscott Rd
Benbrook, TX 76126
(817) 249-4155

Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
084933301OTHER (01)TX
00R86COTHER (01)
195476005MEDICAID (05)TX

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1952504276 ROBERT STEPHEN KROMBACH M.D.
Individual
Obstetrics & Gynecology2800 E BROAD ST STE 100
MANSFIELD, TX 76063
(682) 518-1035
1275736480DR. HEATHER JARRELL HAVENER M.D.
Individual
Obstetrics & Gynecology2800 E BROAD ST STE 100
MANSFIELD, TX 76063
(682) 518-1035
1770994766 ANGALENE DEAPEN JACKSON DO
Individual
Obstetrics & Gynecology2800 E BROAD ST STE 100
MANSFIELD, TX 76063
(682) 518-1035
1154521029 HEATHER HOLDER GARDOW MD
Individual
Obstetrics & Gynecology2800 E BROAD ST STE 100
MANSFIELD, TX 76063
(682) 518-1035

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.