Active NPI
Paola A. Moreno
- Acupuncturist
- Selden, NY
National Provider Identifier
1033550025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 005115
- Practice address
- 1305 Middle Country Rd Ste 11
Selden, NY 11784-2554 - Phone
- (631) 219-6987
- NPI assigned
- Jul 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 020100 | NY | |
| Acupuncturist | 171100000X | 005115 | NY | Primary |
Addresses
Primary practice location
1305 Middle Country Rd Ste 11
Selden, NY 11784-2554
Mailing address
1305 Middle Country Rd Ste 11
Selden, NY 11784-2554
Phone (631) 219-6987
Other practice location 1
209 Broadway
Amityville, NY 11701-2705
Phone (631) 691-0200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005115 | NY | MD | Optometrist |
| 020100 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amityville Acupuncture & Massage | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Amityville Acupuncture & Wellness
- Health Service Clinic/Center
- Amityville, NY
- NPI 1225350762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1033550025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 MIDDLE COUNTRY RD STE 11",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842554",
"telephone_number": "631-219-6987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 MIDDLE COUNTRY RD STE 11",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842554",
"telephone_number": "631-219-6987"
}
],
"practiceLocations": [
{
"address_1": "209 Broadway",
"address_purpose": "LOCATION",
"city": "Amityville",
"state": "NY",
"postal_code": "117012705",
"country_code": "US",
"telephone_number": "631-691-0200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORENO",
"first_name": "PAOLA",
"middle_name": "A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NY",
"license": "020100",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "005115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.