Individual provider Active NPI

Moses J Keng, MD

  • Physical Medicine & Rehabilitation Physician
  • Carrollton, TX
National Provider Identifier
1104832765
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
M1181 Issued in TX
Practice address
2245 Marsh LN
Carrollton, TX 75006
Phone
(972) 416-1764
Fax
(972) 416-5890
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X M1181 TX Primary

Addresses

Primary practice location

2245 Marsh LN
Carrollton, TX 75006

Mailing address

PO Box 678459
Dallas, TX 75267-8459
Phone (972) 416-1764

Other identifiers 2

IdentifierTypeStateIssuer
200554801MedicaidTX
8X6400OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050622000781 TX Practitioner - Physical Medicine and Rehabilitation 8527003318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2245 Marsh LN
Carrollton, TX 75006-2612
Phone (847) 989-0123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1181TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
National Rehabilitation Physicians PA Physical Medicine & Rehabilitation CurrentSince Nov 1, 2006 Accepting new patients

Locations

2245 Marsh Ln
Carrollton, TX 75006
Phone (847) 989-0123

1350 E Lookout Dr
Richardson, TX 75082
Phone (972) 220-2000

Interoperability endpoints

  • Direct secure messaging: dmcmkeng@yourcarecommunity.org

Organizations & group practices 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1104832765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678459",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678459",
            "telephone_number": "972-416-1764",
            "fax_number": "972-416-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 MARSH LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75006",
            "telephone_number": "972-416-1764",
            "fax_number": "972-416-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENG",
        "first_name": "MOSES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "M1181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200554801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X6400",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.