Ilene M Moss, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MB05693500 Issued in NJ

Practice address

11 Saddle Rd
Cedar Knolls, NJ 07927-1901

Phone

(973) 267-2122

Fax

(973) 292-1466

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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.

• Practice Associates Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385

  Pediatrics

  Medicare reassignment NPD
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1124059977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SADDLE RD",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271901",
            "telephone_number": "973-267-2122",
            "fax_number": "973-292-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "ILENE",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB05693500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7185103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel E Morgan, PH.D.
• Mayumi A. Mori, M.D.
• Jaime A Morley, PA-C
• Brianna Marie Mormile, CCC-SLP
• Morris Guild of Psychotherapy LLC
• Leonard J Moss, D.O.
• Gregory Mulford, M.D.
• Sujatha S Murthy, MD
• L Eleonora Narbone
• Jillian Nati, FNP

• Pediatrics Physician in Cedar Knolls, NJ
• Providers in Cedar Knolls, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.

Verify at the official NPI Registry.