Active NPI
Peter J Moses, DDS
- Dentist
- Liverpool, NY
National Provider Identifier
1023310364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 055199
- Practice address
- 4820 West Taft Road
Suite 214
Liverpool, NY 13088 - Phone
- (315) 413-1100
- Fax
- (315) 413-0710
- NPI assigned
- Nov 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 055199 | NY | Primary |
Addresses
Primary practice location
4820 West Taft Road
Suite 214
Liverpool, NY 13088
Mailing address
4820 West Taft Road
Suite 214
Liverpool, NY 13088
Phone (315) 413-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 24, 2015 through Dec 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055199 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endodontic Specialists, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Liverpool, NY
- NPI 1720258205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448928000000",
"number": "1023310364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4820 WEST TAFT ROAD",
"address_2": "SUITE 214",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "13088",
"telephone_number": "315-413-1100",
"fax_number": "315-413-0710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4820 WEST TAFT ROAD",
"address_2": "SUITE 214",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "13088",
"telephone_number": "315-413-1100",
"fax_number": "315-413-0710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSES",
"first_name": "PETER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-18",
"last_updated": "2015-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "055199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.