Active NPI
Kevin Moss, M.D.
- Surgery Physician
- Menomonee Falls, WI
National Provider Identifier
1114991734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 32039
- Practice address
- W180N7950 Town Hall Rd
Menomonee Falls, WI 53051-4049 - Phone
- (262) 255-2500
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 32039 | WI | Primary |
Addresses
Primary practice location
W180N7950 Town Hall Rd
Menomonee Falls, WI 53051-4049
Mailing address
W180N7950 Town Hall Rd
Menomonee Falls, WI 53051-4049
Phone (262) 255-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31703300 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32039 | WI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390780800000",
"number": "1114991734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W180N7950 TOWN HALL RD",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530514049",
"telephone_number": "262-255-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W180N7950 TOWN HALL RD",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530514049",
"telephone_number": "262-255-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "KEVIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2014-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "32039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31703300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.