Individual provider Active NPI

Neil I Moscoso, RPT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1043402605
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 23106 Issued in FL
Practice address
11565 Harts Rd
Therapy
Jacksonville, FL 32218-3777
Phone
(904) 751-1834
NPI assigned
Aug 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 23106 FL Primary

Addresses

Primary practice location

11565 Harts Rd
Therapy
Jacksonville, FL 32218-3777

Mailing address

6710 Collins Rd
Apt. 1111
Jacksonville, FL 32244-5879
Phone (619) 701-2040

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 23106FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1043402605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 COLLINS RD",
            "address_2": "APT. 1111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445879",
            "telephone_number": "619-701-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 HARTS RD",
            "address_2": "THERAPY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183777",
            "telephone_number": "904-751-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCOSO",
        "first_name": "NEIL",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 23106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.