Moses Tabe Ambilichu, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2011019835 Issued in MO

Practice address

3700 I 70 Dr SE Ste 110
Columbia, MO 65201-6587

Phone

(888) 410-5230

NPI assigned

Jun 20, 2008

Last updated

Oct 5, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS, TX, WI, GA5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Specialty

Psychiatry

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Success Health System LLCGroup PAC ID 2961787809, 7 clinicians

Nevada City HospitalGroup PAC ID 9830095280, 87 clinicians

Shawnee Mission Medical Center IncGroup PAC ID 9537119037, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Nevada City Hospital

  dba Nevada Regional Medical Center

  • Rural Acute Care Hospital
  • Nevada, MO
  • NPI 1942283866
  Medicare reassignment Care Compare group NPD
• Shawnee Mission Medical Center Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690
  Medicare reassignment Care Compare group NPD
• Success Health System, LLC

  • Psychiatry Physician
  • Columbia, MO
  • NPI 1508310293

  GA, KS, TX

  Medicare reassignment Care Compare group
• Chestnut Health Systems Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bloomington, IL
  • NPI 1366431686

  MO

  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System in Eau Claire

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• River Region Psychiatry Associates LLC

  dba Ally Psychiatry

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497

  MO

  Medicare reassignment NPD
• Leeker Enterprises Inc

  dba Reflections Counsulting

  • Clinical Social Worker
  • Kennett, MO
  • NPI 1932506524
  NPD
• Nevada City Hospital

  dba Nevada Medical Clinic

  • Rural Health Clinic/Center
  • Nevada, MO
  • NPI 1730805136
  NPD
• Chestnut Health Systems Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wood River, IL
  • NPI 1235941311
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - Oakridge in Mondovi

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD
• Shawnee Mission Medical Center Inc

  dba AdventHealth Shawnee Mission

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shawnee Mission Medical Center Inc

  dba AdventHealth Shawnee Mission

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • Clinical Medical Laboratory
  • Merriam, KS
  • NPI 1235792003

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1073774238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 716",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652050716",
            "telephone_number": "888-595-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 I 70 DR SE STE 110",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016587",
            "telephone_number": "888-410-5230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11695 S Blackbob Rd",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660621058",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Chapel Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301351739",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4429 S River Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640554659",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12401 Olive Blvd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Creve Coeur",
            "state": "MO",
            "postal_code": "631415448",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Chapel Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301351739",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "fax_number": "573-271-5108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2010 S Buckner Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752171804",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "fax_number": "573-271-5108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2805 E 19th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986614614",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "fax_number": "573-271-5108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Interstate 70 Dr SE Ste C",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652016583",
            "country_code": "US",
            "telephone_number": "888-410-5230",
            "fax_number": "573-271-5108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABE AMBILICHU",
        "first_name": "MOSES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "94029",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "U0278",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04-39077",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2011019835",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "IMLC.MD.61663049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Sylvester, PLPC
• Synergos Medical, LLC
• Cristina Szatkiewski, RD, LD
• Michael Szewczyk, M.D.
• Pawel Piotr Szurnicki, MD
• Maria Gail Sunico Tacazon, MD
• Andrew Robert Taegel, M.ED., PLPC, CRADC
• Alexander Tagart, MD
• David S Tager, PH.D.
• Mary Elise Taggart, MA, EDS, LPC

• Psychiatry Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; 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.

Verify at the official NPI Registry.