Individual provider Active NPI

Nancy Jayne Moontasri, MD

  • Orthopaedic Hand Surgery Physician
  • Paterson, NJ
National Provider Identifier
1114378650
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
171381 Issued in CA
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-3450
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NJ
Orthopaedic Hand Surgery Physician 207XS0106X 171381 CA Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

4860 Y Street, Suite 3800
Sacramento, CA 95817
Phone (916) 734-5885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20221018000206 NJ Practitioner - Hand Surgery 1951777804

Care Compare profile

Medicare Care Compare
Specialty
Hand Surgery
Education
University of California, Davis School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

106 Prospect St
Suite 3
Ridgewood, NJ 07450-4499

Hospital & facility affiliations

  • Valley Hospital Hospital, Paramus, NJ, CCN 310012
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171381CAMDOrthopaedic Hand Surgery Physician

Interoperability endpoints

  • Direct secure messaging: nancy.moontasri@ppos.directbygreenway.com

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1114378650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y STREET, SUITE 3800",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-5885",
            "fax_number": "916-734-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONTASRI",
        "first_name": "NANCY",
        "middle_name": "JAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "171381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.