Individual provider Active NPI

Holly Moskos, O.D.

  • Optometrist
  • Middleboro, MA
National Provider Identifier
1174535173
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4354 Issued in MA
Practice address
511 W Grove St
Suite #101
Middleboro, MA 02346-1458
Phone
(508) 947-7321
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4354 MA Primary

Addresses

Primary practice location

511 W Grove St
Suite #101
Middleboro, MA 02346-1458

Mailing address

212 Forbes Rd
Rochester, MA 02770-1039
Phone (774) 406-9226

Other identifiers 2

IdentifierTypeStateIssuer
W17490OtherMEDICARE
0708194MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040809000604 MA Practitioner - Optometry 8729050984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

511 W Grove St
Suite 101
Middleboro, MA 02346-1479
Phone (508) 947-7321

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4354MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Savard & Moskos Eye Health Care, LLC CurrentSince Jul 21, 2003 Accepting new patients
Savard & Moskos Eye Health Care, LLC Optometrist CurrentSince Jul 21, 2003 Accepting new patients

Locations

511 W Grove St
Ste 101
Middleboro, MA 02346
Phone (508) 947-7321

Interoperability endpoints

  • Direct secure messaging: holly.moskos@direct.revolutionehr.com

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1174535173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 FORBES RD",
            "city": "ROCHESTER",
            "state": "MA",
            "postal_code": "027701039",
            "telephone_number": "774-406-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W GROVE ST",
            "address_2": "SUITE #101",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461458",
            "telephone_number": "508-947-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKOS",
        "first_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W17490",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0708194",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleboro, MA

Sources for this page

Verify at the official NPI Registry.