Individual provider Active NPI

Moise Levy, MD

  • Pediatric Dermatology Physician
  • Austin, TX
National Provider Identifier
1013097419
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
F4210 Issued in TX
Practice address
1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone
(512) 628-1920
Fax
(512) 628-1921
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F4210 TX
Pediatric Dermatology Physician 207NP0225X F4210 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078

Mailing address

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone (512) 628-1920

Other identifiers 1

IdentifierTypeStateIssuer
134853409MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20080312000301 TX Practitioner - Dermatology 3678658861 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F4210TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group Current Accepting new patients
Dell Children'S Medical Group CurrentSince Feb 1, 2008 Accepting new patients
Dell Children'S Medical Group Pediatric Dermatology CurrentSince Feb 1, 2008 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Organizations & group practices 3

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1013097419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1920",
            "fax_number": "512-628-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1920",
            "fax_number": "512-628-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "MOISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F4210",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "TX",
            "license": "F4210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134853409",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.