Individual provider Active NPI

Joseph M Moran, DPM

  • Podiatrist
  • Lebanon, OH
National Provider Identifier
1003819848
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002279 Issued in OH
Practice address
210 Mound St
Lebanon, OH 45036-1937
Phone
(513) 932-4961
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36002279 OH Primary

Addresses

Primary practice location

210 Mound St
Lebanon, OH 45036-1937

Mailing address

PO Box 343
Lebanon, OH 45036-0343
Phone (513) 932-4961

Other identifiers 2

IdentifierTypeStateIssuer
480013753OtherOHRAILROAD MEDICARE
0867138MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007000171 OH Practitioner - Podiatry 0446365878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 Mound St
Lebanon, OH 45036-1937
Phone (513) 932-4961

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue945
Removal or shaving of skin growth169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2279OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Michael Moran Podiatrist CurrentSince Jan 1, 1992 Accepting new patients

Locations

237 E Main St
Hillsboro, OH 45133
Phone (513) 232-8880

210 Mound St
Lebanon, OH 45036
Phone (513) 932-4961

Networks

  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • OH PPO

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1003819848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450360343",
            "telephone_number": "513-932-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MOUND ST",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361937",
            "telephone_number": "513-932-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480013753",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0867138",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

Verify at the official NPI Registry.