Individual provider Active NPI

Suzanne Lynn Moxham, LCSW

  • Clinical Social Worker
  • East Amherst, NY
National Provider Identifier
1104967652
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079054 Issued in NY
Practice address
6495 Transit Rd.
Suite 800
East Amherst, NY 14051
Phone
(716) 418-8531
Fax
(716) 418-8514
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 074271-7 NY
Clinical Social Worker 1041C0700X 079054 NY Primary

Addresses

Primary practice location

6495 Transit Rd.
Suite 800
East Amherst, NY 14051

Mailing address

3020 Bailey Ave - 2ND Floor
Buffalo, NY 14215
Phone (716) 831-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000002 NY Practitioner - Clinical Social Worker 9133361900 Practice locations: Lockport, NY; Wilson, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

335 High St
Wilson, NY 14172-9667
Phone (716) 454-2685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074271-7NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthservices Past Accepting new patients

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1104967652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BAILEY AVE - 2ND FLOOR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-831-1800",
            "fax_number": "716-842-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6495 TRANSIT RD.",
            "address_2": "SUITE 800",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "14051",
            "telephone_number": "716-418-8531",
            "fax_number": "716-418-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOXHAM",
        "first_name": "SUZANNE",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "074271-7",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.