Kristen Marie Moser, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036149103 Issued in IL

Practice address

5359 W Fullerton Ave
Chicago, IL 60639-1450

Phone

(773) 836-2785

Fax

(773) 836-7381

NPI assigned

May 31, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Family Practice

Education

Loyola University of Chicago, Stritch School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristen.moser.1@13158.direct.athenahealth.com

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

• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment Care Compare group NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1609892223
  NPD (past)

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1003264177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5359 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391450",
            "telephone_number": "773-836-2785",
            "fax_number": "773-836-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391450",
            "telephone_number": "773-836-2785",
            "fax_number": "773-836-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.068571",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036149103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Moseley
• Allison Kelsey Moser, APN
• Alyson Moser, LCSW
• Ashley Rae Moser
• Katelynn Mary Moser, LCSW
• Libby Micaela Moser, MS, RDN, LDN
• William James Moser Jr., MD
• Ryder Louise Moses-Kessler, M.S., M.D.
• Carol Arlene Moses-Robinson, MA, PSYD
• Lavonzell Moses-Scott

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.