John Paul Moulder, MDIV, MA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

126 E Chestnut St
Chicago, IL 60611-2014

Phone

(312) 787-8425

NPI assigned

Jul 11, 2018

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heritage Professional Associates LTDGroup PAC ID 6002707262, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Heritage Professional Associates LTD

  • Psychologist
  • Hinsdale, IL
  • NPI 1033244173
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1114403243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E CHESTNUT ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112014",
            "telephone_number": "312-787-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E CHESTNUT ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112014",
            "telephone_number": "312-787-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "MDIV, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol J Mottram, PT
• Landen Archibald Motyka, MSW, LCSW
• William Frederic Motzel, ALMFT
• Alaa Mouhajer
• Tamer Moukaied, DDS
• Zineb Moulekaf
• Kristin Moulton
• Theresa S Moulton, PT
• Sarah Jane Moum, M.D.
• Mount Carmel Medical Center

• Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.