Fredric Moon, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

216307 Issued in NY

Practice address

120 Mineola Blvd
Suite 100
Mineola, NY 11501-4073

Phone

(516) 663-3010

Fax

(516) 663-3026

NPI assigned

Aug 24, 2005

Last updated

Feb 9, 2010By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Obstetrics/Gynecology

Education

New York College of Osteo Medicine of New York Institute of Technology, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Medical Group of the Mount Sinai School of MedicineGroup PAC ID 8921999087, 325 clinicians

Mount Sinai School of MedicineGroup PAC ID 6406096544, 150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Mount Sinai School of Medicine

  dba Mount Sinai Marathon Medical

  • Internal Medicine Physician
  • Oceanside, NY
  • NPI 1508127531
  Medicare reassignment Care Compare group NPD
• North Shore Medical Group of the Mount Sinai School of Medicine

  dba Mount Sinai Doctors Long Island

  • Internal Medicine Physician
  • Greenlawn, NY
  • NPI 1275640609
  Medicare reassignment Care Compare group NPD
• Mount Sinai School of Medicine

  • Psychiatry Physician
  • Hempstead, NY
  • NPI 1508333956
  NPD
• Mount Sinai School of Medicine

  • Obstetrics & Gynecology Physician
  • Oceanside, NY
  • NPI 1841767993
  NPD
• North Shore Medical Group of the Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Wantagh, NY
  • NPI 1992417323

  Obstetrics & Gynecology

  NPD
• South Nassau Communities Hospital

  • General Acute Care Hospital
  • Oceanside, NY
  • NPI 1922079094
  NPD (past)

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

• South Nassau Communities Hospital

  • General Acute Care Hospital
  • Oceanside, NY
  • NPI 1922079094
  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1104819242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 100",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-3010",
            "fax_number": "516-663-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 100",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-3010",
            "fax_number": "516-663-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "FREDRIC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "216307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02382350",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Montefiore Medical Center
• Berrin Monteleone, MD
• Frank Antonio Monteleone, M.D.
• Grace Monteleone, P.A.
• Carlos H. Montoya-Iraheta, M.D.
• Kevin Moran, MD
• Thomas Moran, CCC-SLP, TSSLD
• Joseph John Moreira, MD
• Solomon S. Morgenstern, M.D.
• John N Moricco, M.D.

• Obstetrics & Gynecology Physician in Mineola, NY
• Providers in Mineola, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; 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.