Organization Active NPI

Moses Mobile Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Huntington Beach, CA
National Provider Identifier
1053062463
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MOSES MOBILE PHYSICAL THERAPY LLC
Practice address
4352 Pickwick Cir Apt 311
Huntington Beach, CA 92649-3126
Phone
(903) 306-8831
NPI assigned
Jan 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Dr. Gregory Steven Moses, PT, DPT
Title
Owner
Phone
(714) 264-0243

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4352 Pickwick Cir Apt 311
Huntington Beach, CA 92649-3126

Mailing address

4352 Pickwick Cir Apt 311
Huntington Beach, CA 92649-3126
Phone (903) 306-8831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427001076 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0648667303 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA; Huntington Beach, CA

National Provider Directory

National Provider Directory

Locations

18030 Magnolia St
Fountain Valley, CA 92708
Phone (619) 483-1141

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1053062463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4352 PICKWICK CIR APT 311",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493126",
            "telephone_number": "903-306-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 PICKWICK CIR APT 311",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493126",
            "telephone_number": "903-306-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES MOBILE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-264-0243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.