Active NPI
Melissa Moss, LCSW
- Clinical Social Worker
- Tampa, FL
National Provider Identifier
1124626882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW19113
- Practice address
- 3515 E Fletcher Ave
Tampa, FL 33613-4706 - Phone
- (813) 821-8038
- NPI assigned
- Oct 15, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149022548 | IL | |
| Clinical Social Worker | 1041C0700X | CSW09927672 | CO | |
| Clinical Social Worker | 1041C0700X | SW19113 | FL | Primary |
Addresses
Primary practice location
3515 E Fletcher Ave
Tampa, FL 33613-4706
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Other practice location 1
2670 NE Pinecrest Lakes Blvd
Jensen Beach, FL 34957-4638
Phone (312) 772-7794
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112714300 | Medicaid | FL | |
| 149022548 | Medicaid | IL |
Other names 1
- Melissa Festa
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | home | Health Information Exchange (HIE) | |
| Direct Messaging Address | mfesta209267@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1951 NW 7TH Ave
FL 3
Miami, FL 33136-1104
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW09927672 | CO | MD | Clinical Social Worker |
| 149022548 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa General Hospital | Current | Accepting new patients | |
| Brave Health Inc. | Current | Accepting new patients |
Locations
1951 NW 7th Ave
Fl 3
Miami, FL 33136
Phone (305) 297-4749
Interoperability endpoints
- mfesta209267@direct.tgh.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Miami, FL
- NPI 1821588674
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1124626882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 E FLETCHER AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336134706",
"telephone_number": "813-821-8038"
}
],
"practiceLocations": [
{
"address_1": "2670 NE Pinecrest Lakes Blvd",
"address_purpose": "LOCATION",
"city": "Jensen Beach",
"state": "FL",
"postal_code": "349574638",
"country_code": "US",
"telephone_number": "312-772-7794",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOSS",
"first_name": "MELISSA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-15",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149022548",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW09927672",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW19113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112714300",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149022548",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "home",
"affiliation": "N",
"endpointDescription": "home",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2670 NE Pinecrest Lakes Blvd",
"city": "Jensen Beach",
"state": "FL",
"country_code": "US",
"postal_code": "349574638",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mfesta209267@direct.tgh.org",
"affiliation": "N",
"address_1": "3515 E Fletcher Ave",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336134706",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "FESTA",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.