Individual provider Active NPI

Lovern R Moseley, PHD

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1023255742
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9543 Issued in MA
Practice address
1 Boston Medical Center Place
Boston, MA 02118
Phone
(617) 414-5245
Fax
(617) 638-6836
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9543 MA Primary

Addresses

Primary practice location

1 Boston Medical Center Place
Boston, MA 02118

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118

Other identifiers 1

IdentifierTypeStateIssuer
110101045AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130508000487 MA Practitioner - Clinical Psychologist 0648424499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerment Counseling and Psychotherapy CenterGroup PAC ID 2163848375, 4 clinicians

Practice addresses (Care Compare)

1629 Central St
Suite 3
Stoughton, MA 02072-1693
Phone 8667544973102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9543MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Empowerment Counseling and Psychotherapy Center CurrentSince Oct 20, 2014 Accepting new patients

Locations

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

1629 Central St
Ste 3
Stoughton, MA 02072
Phone (617) 344-5589

Interoperability endpoints

  • Direct secure messaging: lmoseley11405@direct.bmc.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1023255742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CENTER PLACE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-5245",
            "fax_number": "617-638-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "LOVERN",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110101045A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.