Individual provider Active NPI

Jonina L Moskowitz, PSYD

  • Clinical Psychologist
  • Virginia Beach, VA
National Provider Identifier
1053493213
Registry record updated Nov 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002586 Issued in VA
Practice address
297 Independence Blvd
Pembroke Six, Ste. 212
Virginia Beach, VA 23462-2911
Phone
(757) 285-0640
Fax
(757) 473-2104
NPI assigned
Oct 19, 2006
Last updated
Nov 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810002586 VA Primary

Addresses

Primary practice location

297 Independence Blvd
Pembroke Six, Ste. 212
Virginia Beach, VA 23462-2911

Mailing address

297 Independence Blvd
Pembroke Six, Ste. 212
Virginia Beach, VA 23462-2911
Phone (757) 285-0640

Other identifiers 3

IdentifierTypeStateIssuer
1053493213MedicaidVA
1053493212OtherOPTIMA BEHAVIORAL HEALTH
460005OtherMANAGED HEALTH NETWORK

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
0810002586VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321142400000",
    "number": "1053493213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 INDEPENDENCE BLVD",
            "address_2": "PEMBROKE SIX, STE. 212",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622911",
            "telephone_number": "757-285-0640",
            "fax_number": "757-473-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 INDEPENDENCE BLVD",
            "address_2": "PEMBROKE SIX, STE. 212",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622911",
            "telephone_number": "757-285-0640",
            "fax_number": "757-473-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKOWITZ",
        "first_name": "JONINA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053493213",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA BEHAVIORAL HEALTH",
            "identifier": "1053493212",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "460005",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2011; 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.