EHTESHAM MUSTAFA PA-C
NPI 1104484609
Physician Assistant in Glen Allen, VA

Q: What is Ehtesham Mustafa's NPI number?

The NPI number for Ehtesham Mustafa is 1104484609. It was assigned to this individual provider in the NPPES registry on May 30, 2019.

Q: What is Ehtesham Mustafa's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Ehtesham Mustafa was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2019PECOS EnrolledAccepts Medicare Assignment

4900 COX RD STE 150, GLEN ALLEN, VA 23060(804) 346-1780 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ehtesham Mustafa Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EHTESHAM MUSTAFA PA-C (NPI 1104484609) is an individual physician assistant in Glen Allen, Virginia and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with Bon Secours St Marys Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1104484609

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameEHTESHAM MUSTAFACredential: PA-C

Location Address4900 COX RD STE 150Glen Allen, VA 23060-6507

Mailing Address4900 Cox Rd Ste 150Glen Allen, VA 23060-6507 · (804) 346-1780

Phone(804) 346-1780

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 30, 2019

Last NPPES UpdateMarch 16, 2022

NPPES CertifiedMarch 16, 2022

✔ NPI 1104484609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4900 COX RD STE 150, Glen Allen, VA 23060

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ehtesham Mustafa Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608208822

PECOS Enrollment IDI20220110002731

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

200 services158 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

156 services123 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

35 services35 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bon Secours St Marys Hospital

Acute Care Hospitals · Richmond, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number490059

Location5801 Bremo RdRichmond, VA 23226 · Richmond City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAYLEY BERRY RN

Nurse Practitioner (Family)