Individual provider Active NPI

Tina Allyn Moser, OT/L

  • Community Health Worker
  • Clifton Park, NY
National Provider Identifier
1033410923
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
009429-1 Issued in NY
Practice address
2 Longleaf MDWS
Clifton Park, NY 12065-2134
Phone
(518) 877-8716
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 009429-1 NY Primary

Addresses

Primary practice location

2 Longleaf MDWS
Clifton Park, NY 12065-2134

Mailing address

2 Longleaf MDWS
Clifton Park, NY 12065-2134
Phone (518) 877-8716

Other identifiers 1

IdentifierTypeStateIssuer
009429-1OtherNYLINCENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
009429-1NYMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1033410923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LONGLEAF MDWS",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652134",
            "telephone_number": "518-877-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LONGLEAF MDWS",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652134",
            "telephone_number": "518-877-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "TINA",
        "middle_name": "ALLYN",
        "name_prefix": "Mrs.",
        "credential": "OT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "009429-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LINCENSE #",
            "identifier": "009429-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.