Active NPI
Renata Milena Stoszek Moon, M.D.
- Pediatrics Physician
- Spokane, WA
National Provider Identifier
1154376101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME154557
- Practice address
- 322 W North River Dr
Spokane, WA 99201-3208 - Phone
- (509) 324-6464
- NPI assigned
- May 24, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME154557 | FL | Primary |
| Pediatrics Physician | 208000000X | MD00043974 | WA |
Addresses
Primary practice location
322 W North River Dr
Spokane, WA 99201-3208
Mailing address
6451 N Federal Hwy
Fort Lauderdale, FL 33308-1402
Phone (877) 336-6077
Other practice location 1
101 W 8th Ave
Spokane, WA 99204-2307
Phone (509) 474-2731
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AB32999 | Other | WA | MEDICARE GROUP |
| 8402687 | Medicaid | WA |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Pediatrics | Current | Accepting new patients |
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| TCH Pediatric Associates, Inc | Pediatrics | Past | Accepting new patients |
Locations
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996
Interoperability endpoints
- rmoon38058@ghc.direct-ci.net
- rmoon1162756@ahs.direct-ci.com
Organizations & group practices 3
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.
-
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- Pediatrics Physician
- Houston, TX
- NPI 1225038326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670457600000",
"number": "1154376101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6451 N FEDERAL HWY",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333081402",
"telephone_number": "877-336-6077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 W NORTH RIVER DR",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992013208",
"telephone_number": "509-324-6464"
}
],
"practiceLocations": [
{
"address_1": "101 W 8th Ave",
"address_purpose": "LOCATION",
"city": "Spokane",
"state": "WA",
"postal_code": "992042307",
"country_code": "US",
"telephone_number": "509-474-2731",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOON",
"first_name": "RENATA",
"middle_name": "MILENA STOSZEK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2022-12-08",
"certification_date": "2022-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME154557",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00043974",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "AB32999",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8402687",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.