Individual provider Active NPI

Rafael Mosery, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1013041102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38744 Issued in NY
Practice address
2426 Ocean Pkwy
Brooklyn, NY 11235-6108
Phone
(718) 645-8300
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38744 NY Primary

Addresses

Primary practice location

2426 Ocean Pkwy
Brooklyn, NY 11235-6108

Mailing address

2426 Ocean Pkwy
Brooklyn, NY 11235-6108
Phone (718) 645-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160413000564 NY Order and Referring Only - DentistPractitioner - Dentist 4385942069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38744NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013041102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356108",
            "telephone_number": "718-645-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356108",
            "telephone_number": "718-645-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSERY",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "38744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.