Individual provider Active NPI

Jonathan Daniel Mozena, M.D.

  • Allergy & Immunology Physician
  • Fredericksburg, VA
National Provider Identifier
1093757163
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101239028 Issued in VA
Practice address
511 Park Hill Drive
Fredericksburg, VA 22401-3377
Phone
(540) 371-5660
Fax
(540) 372-6920
NPI assigned
Jun 12, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 0101239028 VA Primary

Addresses

Primary practice location

511 Park Hill Drive
Fredericksburg, VA 22401-3377

Mailing address

Dept. 453 PO Box 1000
Memphis, TN 38148-0001
Phone (828) 575-2625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060324000327 VA Practitioner - Allergy/Immunology 3173531670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Iowa, RJ & L Carver College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

511 Park Hill Dr
Fredericksburg, VA 22401-3377
Phone (540) 371-5660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239028VAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1508468638 Allergy & Immunology CurrentSince Jul 15, 2007 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology CurrentSince Jul 15, 2007 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients

Locations

4710 Spotsylvania Pkwy
Ste 205
Fredericksburg, VA 22407
Phone (540) 710-2324

511 Park Hill Dr
Fredericksburg, VA 22401
Phone (540) 371-5660

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1093757163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 453 PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PARK HILL DRIVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013377",
            "telephone_number": "540-371-5660",
            "fax_number": "540-372-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZENA",
        "first_name": "JONATHAN",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101239028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.