Active NPI
Kristi B Moseley, OD
- Optometrist
- Woodward, OK
National Provider Identifier
1154473254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2163
- Practice address
- 1602 9TH St
Woodward, OK 73801-4610 - Phone
- (580) 254-5060
- Fax
- (580) 256-1100
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2163 | OK | Primary |
Addresses
Primary practice location
1602 9TH St
Woodward, OK 73801-4610
Mailing address
PO Box 983
Woodward, OK 73802-0983
Phone (580) 254-5060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100763350A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100915000162 | OK | Practitioner - Optometry | 6305961335 | Practice locations: Woodward, OK |
| O20100930008883 | OK | DME Supplier - Physician - Optometrist | 2668593492 | Practice locations: Woodward, OK |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1602 9TH St
Woodward, OK 73801-4610
Phone (580) 254-5060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1154473254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 983",
"city": "WOODWARD",
"state": "OK",
"postal_code": "738020983",
"telephone_number": "580-254-5060",
"fax_number": "580-256-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1602 9TH ST",
"city": "WOODWARD",
"state": "OK",
"postal_code": "738014610",
"telephone_number": "580-254-5060",
"fax_number": "580-256-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSELEY",
"first_name": "KRISTI",
"middle_name": "B",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "2163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100763350A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodward, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.