Shahriar Moossavi, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

200200745 Issued in NC

Practice address

Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(336) 716-2255

NPI assigned

Dec 8, 2005

Last updated

Mar 22, 2013By the provider in NPPES

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

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nephrology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miller Street Dialysis Center Dialysis facility, Winston Salem, NC, CCN 342667
• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
• Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoossavi2755022@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Miller Street Dialysis Center of Wake Forest University

  dba Miller Street Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Winston Salem, NC
  • NPI 1407000540

  Dialysis facility

  Care Compare affiliation Name & address match
• Lexington Medical Center

  • General Acute Care Hospital
  • Lexington, NC
  • NPI 1417958331
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Winston East Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1144205584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSSAVI",
        "first_name": "SHAHRIAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "200200745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89131PM",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0074N",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "800195",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B7288",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "131PM",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5886881",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7407457",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004959000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin M Moorman Spangler, PHARMD
• Katherine Lee Moos, MA, ATC
• Tyler Scott Moos, ATC
• Beverly Dawn Moose, MD
• Melissa Moose, OT
• Lorenzo Luis Morales, MS, PTA, ATC-L
• Kellie Alice Moran, LCSW
• Mary Melyssa Moran, CRNA
• Moravian Home Incorporated (Salemtowne)
• Jan Suliman Moreb, MD

• Nephrology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nephrology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.