Individual provider Active NPI

Davia Gaelin Moss, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1013469873
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340815 Issued in NY
Practice address
725 E Adams St FL 4
Syracuse, NY 13210-2576
Phone
(315) 464-5831
Fax
(314) 464-2030
NPI assigned
Oct 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 645775 NY
Family Nurse Practitioner 363LF0000X F340815 NY Primary

Addresses

Primary practice location

725 E Adams St FL 4
Syracuse, NY 13210-2576

Mailing address

725 E Adams St FL 4
Syracuse, NY 13210-2576

Other identifiers 1

IdentifierTypeStateIssuer
04635810MedicaidNY

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109002686 NY Practitioner - Nurse Practitioner 3274814181 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
645775NYMDRegistered Nurse
F340815NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Service Group CurrentSince Dec 1, 2016 Accepting new patients
Ohr Health, Davia Moss Nurse Practitioner in Family Health, PLLC Family Current Accepting new patients
Suny Health Science Center at Syracuse Family CurrentSince Jun 29, 2023 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Jun 29, 2023 Accepting new patients

Locations

90 Presidential Plz
Syracuse, NY 13202
Phone (315) 464-3836

725 E Adams St
Syracuse, NY 13210
Phone (315) 464-4357

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

725 E Adams St
Fl 4
Syracuse, NY 13210
Phone (315) 464-4686

Organizations & group practices 4

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": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1013469873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E ADAMS ST FL 4",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102576",
            "fax_number": "314-464-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E ADAMS ST FL 4",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102576",
            "telephone_number": "315-464-5831",
            "fax_number": "314-464-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DAVIA",
        "middle_name": "GAELIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "645775",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04635810",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.