Active NPI
Micheal L Moretti, MD
- Obstetrics & Gynecology Physician
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 152103
- Practice address
- 355 Bard Ave
Gynecology/ Perinatology
Staten Island, NY 10310-1664 - Phone
- (718) 818-3278
- NPI assigned
- Oct 2, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 152103 | NY | Primary |
Addresses
Primary practice location
355 Bard Ave
Gynecology/ Perinatology
Staten Island, NY 10310-1664
Mailing address
450 W 33Rd St
PBS 12TH Floor
New York, NY 10001-2603
Phone (212) 356-4474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01252377 | Medicaid | NY |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152103 | NY | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TBHC Physician Services PC | Obstetrics & Gynecology | Current | Accepting new patients |
| Amboy Medical Practice PC | Current | Accepting new patients | |
| Amboy Medical Practice PC | Obstetrics & Gynecology | Current | Accepting new patients |
| The Brooklyn Hospital Center | Past | Accepting new patients | |
| Richmond University Medical Center | Past | Accepting new patients |
Locations
121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604
4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015
355 Bard Ave
Rm 208
Staten Island, NY 10310
Phone (718) 876-2979
275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829
355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- mmoretti17735@prd.direct.tbh.org
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Staten Island, NY
- NPI 1700037975
Obstetrics & Gynecology
-
- Diagnostic Radiology Physician
- Staten Island, NY
- NPI 1104692672
-
- Multi-Specialty Clinic/Center
- Staten Island, NY
- NPI 1811054042
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1326046467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033202056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 W 33RD ST",
"address_2": "PBS 12TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100012603",
"telephone_number": "212-356-4474",
"fax_number": "212-356-4608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVE",
"address_2": "GYNECOLOGY/ PERINATOLOGY",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101664",
"telephone_number": "718-818-3278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORETTI",
"first_name": "MICHEAL",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NY",
"license": "152103",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01252377",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.