Individual provider Active NPI

William James Moss, M.D.

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1003182395
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(508) 395-4189
Fax
(555) 555-5555
NPI assigned
Mar 30, 2012
Last updated
Sep 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Otolaryngology Physician 207Y00000X A129081 CA

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

622 Pheasant HL
Acton, MA 01718-1009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MP2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150917002653 CA Practitioner - Otolaryngology 4587971817 Reassigns benefits to 1 organization
I20180810000208 MP Practitioner - Otolaryngology 4587971817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, San Francisco School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Lower Navy Hill Rd
Saipan, MP 96950
Phone (670) 234-8950

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
129081CAMDClinical Social Worker
A129081CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Aug 4, 2015 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Jul 5, 2018 Accepting new patients
Family Health Centers of San Diego, Inc Otolaryngology CurrentSince Aug 4, 2015 Accepting new patients
Family Health Centers of San Diego, Inc Otolaryngology Current Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Jul 5, 2018 Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1003182395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 PHEASANT HL",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017181009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "508-395-4189",
            "fax_number": "555-555-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-30",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A129081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.