Alvaro J Moreno OD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ALVARO J MORENO OD PC

Practice address

598 E Central Ave
Petal, MS 39465-2957

Phone

(601) 450-3937

Fax

(601) 909-6104

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alvaro J Moreno, ODNPI 1548347834

Title

Owner

Phone

(601) 549-1553

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alvaro Jorge Moreno, O.D.

  • Optometrist
  • Petal, MS
  • NPI 1548347834

  MS, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Alvaro Paul Moreno, OD

  • Optometrist
  • Petal, MS
  • NPI 1518577337

  MS, Optometrist

  Medicare reassignment Care Compare group NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1013085935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 E CENTRAL AVE",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652957",
            "telephone_number": "601-450-3937",
            "fax_number": "601-909-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 E CENTRAL AVE",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652957",
            "telephone_number": "601-450-3937",
            "fax_number": "601-909-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVARO J MORENO OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-549-1553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "610",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08637209",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon D Adams, LMFT
• Kimberly Ann Ainsworth, PHARMD
• Charles Alumbaugh
• Hannah Roberts Badon
• Jennifer Lois Barbieri, LCSW
• Bedford Care Center of Petal, LLC
• Lawrence C Bender III, PHARMD
• Alisa Berteau, PHARM D, FDN

• All providers in Petal, MS
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.