Individual provider Active NPI

Richard S Moraites, MD

  • Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1154482107
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35021342M Issued in OH
Practice address
7717 Montgomery Road
Cincinnati, OH 45236-4201
Phone
(513) 793-4021
Fax
(513) 793-4078
NPI assigned
Dec 13, 2006
Last updated
Jul 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35021342M OH Primary
MOHS-Micrographic Surgery Physician 207ND0101X 35021342M OH

Addresses

Primary practice location

7717 Montgomery Road
Cincinnati, OH 45236-4201

Mailing address

7717 Montgomery Road
Cincinnati, OH 45236-4201
Phone (513) 793-4021

Other identifiers 1

IdentifierTypeStateIssuer
6126105MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35021342MOHMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1154482107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 MONTGOMERY ROAD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452364201",
            "telephone_number": "513-793-4021",
            "fax_number": "513-793-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 MONTGOMERY ROAD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452364201",
            "telephone_number": "513-793-4021",
            "fax_number": "513-793-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAITES",
        "first_name": "RICHARD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35021342M",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35021342M",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6126105",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.