Individual provider Active NPI

Michael Christopher Moy, D.O.

  • Family Medicine Physician
  • Elmhurst, NY
National Provider Identifier
1164623708
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
193909 Issued in NY
Practice address
8710 Queens Blvd FL 1
Elmhurst, NY 11373-4419
Phone
(917) 396-4343
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 193909 NY Primary

Addresses

Primary practice location

8710 Queens Blvd FL 1
Elmhurst, NY 11373-4419

Mailing address

8710 Queens Blvd FL 1
Elmhurst, NY 11373-4419
Phone (917) 396-4343

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200526002837 NY Practitioner - Family Practice 1951722198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8710 Queens Blvd
Elmhurst, NY 11373-4419
Phone (917) 396-4343

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BRTC Ni Inc Family Medicine PastSince Feb 16, 2020 Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mim9355@direct.nyp.org

Organizations & group practices 2

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1164623708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 QUEENS BLVD FL 1",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734419",
            "telephone_number": "917-396-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 QUEENS BLVD FL 1",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734419",
            "telephone_number": "917-396-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOY",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "193909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.