Individual provider Active NPI

Gregory B Moss, MD

  • Infectious Disease Physician
  • Seattle, WA
National Provider Identifier
1114914660
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD00026241 Issued in WA
Practice address
515 Minor Ave
Ste 300
Seattle, WA 98104-2120
Phone
(206) 386-9500
Fax
(206) 386-9605
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD00026241 WA Primary

Addresses

Primary practice location

515 Minor Ave
Ste 300
Seattle, WA 98104-2120

Mailing address

PO Box 3489
Seattle, WA 98114-3489
Phone (206) 386-9500

Other practice location 1

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (206) 838-9582

Other identifiers 3

IdentifierTypeStateIssuer
440001717OtherWARR MEDICARE
8127953MedicaidWA
117848OtherWAL & I

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gmoss1042594@wm.providencedirect.org Direct
Direct Messaging Address gmoss1042594@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: gmoss1042594@wm.providencedirect.org

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1114914660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3489",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143489",
            "telephone_number": "206-386-9500",
            "fax_number": "206-386-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "address_2": "STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042120",
            "telephone_number": "206-386-9500",
            "fax_number": "206-386-9605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "206-838-9582",
            "fax_number": "206-386-9622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSS",
        "first_name": "GREGORY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD00026241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "440001717",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8127953",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "117848",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmoss1042594@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "515 Minor Ave",
            "address_2": "Ste 300",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981042120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmoss1042594@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "751 NE Blakely Dr",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980296201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.