NPIMap

Individual provider Active NPI

Rene L. Mosada, M.D.

  • Neurology Physician
  • Joplin, MO
National Provider Identifier
1013906759
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2023022349 Issued in MO
Practice address
100 Mercy Way Ste 460
Joplin, MO 64804-4524
Phone
(417) 556-6876
NPI assigned
Oct 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 7631 SD
Neurology Physician 2084N0400X 224676 NY
Neurology Physician 2084N0400X 2023022349 MO Primary

Addresses

Primary practice location

100 Mercy Way Ste 460
Joplin, MO 64804-4524

Mailing address

100 Mercy Way Ste 460
Joplin, MO 64804-4524
Phone (417) 556-6876

Other practice location 1

201 S Lloyd St
Ste E202
Aberdeen, SD 57401-4552
Phone (605) 622-2605

Other identifiers 1

IdentifierTypeStateIssuer
02267081MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804000636 MO Practitioner - Neurology 4789670423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Saint Louis University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
530 Mercy Clinic Joplin Neurosurgery
Joplin, MO 64804-4524
Phone (417) 556-6876

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7631SDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince Jul 15, 2023 Accepting new patients
Mid-Hudson Family Health Institute Past Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 530
Joplin, MO 64804
Phone (417) 556-3828

100 Mercy Way
Ste 460
Joplin, MO 64804
Phone (417) 556-5210

Networks

  • IA HMO C-SNP
  • IA HMO
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Organizations & group practices 2

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1129420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1013906759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY STE 460",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY STE 460",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-6876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Lloyd St",
            "address_2": "Ste E202",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574014552",
            "country_code": "US",
            "telephone_number": "605-622-2605",
            "fax_number": "605-622-2606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSADA",
        "first_name": "RENE",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-16",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SD",
            "license": "7631",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "224676",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2023022349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02267081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.