Active NPI
Gerald W Moritz, MD
- Otolaryngology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 32656
- Practice address
- 11125 Dunn Rd
Ste 201
Saint Louis, MO 63136-6132 - Phone
- (314) 362-7509
- Fax
- (314) 362-7522
- NPI assigned
- Oct 6, 2006
- Last updated
- Nov 15, 2021
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 32656 | MO | Primary |
Addresses
Primary practice location
11125 Dunn Rd
Ste 201
Saint Louis, MO 63136-6132
Mailing address
660 S Euclid Ave
CB 8115
Saint Louis, MO 63110-1010
Phone (314) 362-7509
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202102703 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- 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 |
|---|---|---|---|
| Washington University | Current | Accepting new patients | |
| Washington University | Current | Accepting new patients | |
| Christian Hospital Northeast- Northwest | Past | Accepting new patients | |
| Physician Groups LC | Past | Accepting new patients |
Locations
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
1225 Graham Rd
Ste C-1340
Florissant, MO 63031
Phone (314) 953-6093
2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454
11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784
1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170
660 S Euclid Ave
#8115
Saint Louis, MO 63110
Phone (314) 362-7395
11125 Dunn Rd
Ste 201
Saint Louis, MO 63136
Phone (314) 355-5300
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
- gmoritz11095@direct.carenet.org
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1356381842
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1639186760
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1285664268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1154418424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "CB 8115",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-7509",
"fax_number": "314-362-7522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11125 DUNN RD",
"address_2": "STE 201",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366132",
"telephone_number": "314-362-7509",
"fax_number": "314-362-7522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORITZ",
"first_name": "GERALD",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MO",
"license": "32656",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202102703",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "11125 Dunn Rd",
"address_2": "Ste 201",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631366132",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.