Active NPI
Herbert I Moselle, MD
- Otolaryngology Physician
- Plantation, FL
National Provider Identifier
1003890286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 12685
- Practice address
- 201 NW 82ND Ave
Suite 404
Plantation, FL 33324-7808 - Phone
- (954) 472-1212
- Fax
- (954) 473-8265
- NPI assigned
- Dec 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 12685 | FL | Primary |
Addresses
Primary practice location
201 NW 82ND Ave
Suite 404
Plantation, FL 33324-7808
Mailing address
201 NW 82ND Ave
Suite 404
Plantation, FL 33324-7808
Phone (954) 472-1212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 373232100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12685 | FL | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331856000000",
"number": "1003890286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 NW 82ND AVE",
"address_2": "SUITE 404",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333247808",
"telephone_number": "954-472-1212",
"fax_number": "954-473-8265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 NW 82ND AVE",
"address_2": "SUITE 404",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333247808",
"telephone_number": "954-472-1212",
"fax_number": "954-473-8265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSELLE",
"first_name": "HERBERT",
"middle_name": "I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2012-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "12685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "373232100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.