Individual provider Active NPI

Gerald Michael Moschgat, RPH

  • Pharmacist
  • Portage, PA
National Provider Identifier
1154650851
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP030746L Issued in PA
Practice address
617 Main St
Portage, PA 15946-1569
Phone
(814) 736-4351
Fax
(814) 736-9522
NPI assigned
Dec 9, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP030746L PA Primary

Addresses

Primary practice location

617 Main St
Portage, PA 15946-1569

Mailing address

617 Main St
Portage, PA 15946-1569
Phone (814) 736-4351

Other identifiers 1

IdentifierTypeStateIssuer
PP481858OtherPAPA STATE LICENSE #

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP030746LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainline Pharmacy Ebensburg LLC Current Accepting new patients
Mainline Pharmacy Ebensburg, LLC Current Accepting new patients
Mainline Pharmacy Murrysville, LLC Current Accepting new patients
Mainline CPL, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1154650851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 MAIN ST",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "159461569",
            "telephone_number": "814-736-4351",
            "fax_number": "814-736-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 MAIN ST",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "159461569",
            "telephone_number": "814-736-4351",
            "fax_number": "814-736-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCHGAT",
        "first_name": "GERALD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP030746L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE #",
            "identifier": "PP481858",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.