Individual provider Active NPI

Charito Dela Cruz Morada, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1154625192
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045678 Issued in NY
Practice address
105 E 63Rd St Ste 1a-1B
New York, NY 10065-7327
Phone
(212) 581-3030
Fax
(212) 207-8521
NPI assigned
Jan 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 045678 NY Primary

Addresses

Primary practice location

105 E 63Rd St Ste 1a-1B
New York, NY 10065-7327

Mailing address

105 E 63Rd St Ste 1a-1B
New York, NY 10065-7327
Phone (212) 581-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160607001592 NY Order and Referring Only - DentistPractitioner - Dentist 8224328000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Arts at Lexington & 63Rd St PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1154625192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E 63RD ST STE 1A-1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657327",
            "telephone_number": "212-581-3030",
            "fax_number": "212-207-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 63RD ST STE 1A-1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657327",
            "telephone_number": "212-581-3030",
            "fax_number": "212-207-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORADA",
        "first_name": "CHARITO",
        "middle_name": "DELA CRUZ",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.