Active NPI
Roma Moza, MD
- Internal Medicine Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD189242
- Practice address
- 9205 SW Barnes Rd
Portland, OR 97225 - Phone
- (503) 216-2906
- NPI assigned
- Apr 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD189242 | OR | Primary |
| Internal Medicine Physician | 207R00000X | BP10042714 | TX | |
| Pediatrics Physician | 208000000X | Q8577 | TX | |
| Pediatrics Physician | 208000000X | BP10042714 | TX | |
| Pediatrics Physician | 208000000X | MD189242 | OR |
Addresses
Primary practice location
9205 SW Barnes Rd
Portland, OR 97225
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other practice location 1
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-8600
Other practice location 2
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-8600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500754746 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rmoza952807@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Ohio State University College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9205 SW Barnes Rd
FL 1
Portland, OR 97225-6603
Phone (503) 216-2906
Hospital & facility affiliations
- Providence St Vincent Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10042714 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
Locations
9205 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-0790
5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
Interoperability endpoints
- roma.moza.1@17650.direct.athenahealth.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Lake Oswego, OR
- NPI 1023488343
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
Internal Medicine
-
- Infectious Disease Physician
- Portland, OR
- NPI 1568541894
-
- Clinical Pathology Physician
- Portland, OR
- NPI 1831641745
Internal Medicine
-
- Psychiatry Physician
- Portland, OR
- NPI 1760177737
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1063779569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9205 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97225",
"telephone_number": "503-216-2906"
}
],
"practiceLocations": [
{
"address_1": "5323 Harry Hines Blvd",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "753907208",
"country_code": "US",
"telephone_number": "214-645-8600",
"fax_number": "214-645-8601",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5323 Harry Hines Blvd",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "753907208",
"country_code": "US",
"telephone_number": "214-645-8600",
"fax_number": "214-645-8601",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOZA",
"first_name": "ROMA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-20",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD189242",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "BP10042714",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "Q8577",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "BP10042714",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD189242",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500754746",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rmoza952807@oc.providencedirect.org",
"affiliation": "N",
"address_1": "9205 SW Barnes Rd",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "97225",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.