Individual provider Active NPI

Mzingaye Leeroy Gugulethu Moyo, M.D

  • Hospitalist Physician
  • New York, NY
National Provider Identifier
1093027245
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
301461 Issued in NY
Practice address
First Avenue at 16TH Street
New York, NY 10003-0000
Phone
(212) 844-1808
Fax
(212) 420-2025
NPI assigned
Jul 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 40706 IA
Student in an Organized Health Care Education/Training Program 390200000X TRN14935 FL
Hospitalist Physician 208M00000X 301461 NY Primary

Addresses

Primary practice location

First Avenue at 16TH Street
New York, NY 10003-0000

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

281 1st Ave
New York, NY 10003-2925
Phone (212) 844-1808

Other practice location 2

3 S 4th Ave
Marshalltown, IA 50158-2924
Phone (641) 754-5997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20161110000899 NJ Practitioner - HospitalistPractitioner - Internal Medicine 2062641467 Reassigns benefits to 3 organizations
I20230724003105 NY Practitioner - Hospitalist 2062641467 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40706IAMDHospitalist Physician
TRN14935FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of New Jersey, PC Hospitalist CurrentSince Sep 11, 2016 Accepting new patients
St Josephs Medical Group PC CurrentSince Nov 1, 2021 Accepting new patients
St. Joseph'S Healthcare, Inc. CurrentSince Jul 5, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. CurrentSince Sep 11, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

703 Main St
#P
Paterson, NJ 07503

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

281 1st Ave
New York, NY 10003
Phone (212) 844-1808

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1278201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1093027245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FIRST AVENUE AT 16TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100030000",
            "telephone_number": "212-844-1808",
            "fax_number": "212-420-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "281 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100032925",
            "country_code": "US",
            "telephone_number": "212-844-1808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 S 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Marshalltown",
            "state": "IA",
            "postal_code": "501582924",
            "country_code": "US",
            "telephone_number": "641-754-5997",
            "fax_number": "641-754-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYO",
        "first_name": "MZINGAYE",
        "middle_name": "LEEROY GUGULETHU",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-04",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "40706",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN14935",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "301461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.