Active NPI
Rodulfo Moises, M.D.
- Pediatrics Physician
- Clifton, NJ
National Provider Identifier
1174560197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA6309900
- Practice address
- 1040 Clifton Ave
Clifton, NJ 07013-3511 - Phone
- (973) 574-8060
- Fax
- (973) 574-8061
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA6309900 | NJ | Primary |
Addresses
Primary practice location
1040 Clifton Ave
Clifton, NJ 07013-3511
Mailing address
703 Passaic Ave
Clifton, NJ 07012-1824
Phone (973) 574-8060
Other practice location 1
89 Main St
Paterson, NJ 07505
Phone (973) 742-7880
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA6309900 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Josephs University Medical Center Inc. | Past | Accepting new patients | |
| Allwood Pediatrics | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/14309/brand/1/csg/1/fhir/r4
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.
-
- Pediatrics Physician
- Clifton, NJ
- NPI 1447503669
-
- General Acute Care Hospital
- Paterson, NJ
- NPI 1669462420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572220800000",
"number": "1174560197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 PASSAIC AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070121824",
"telephone_number": "973-574-8060",
"fax_number": "973-574-8061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 CLIFTON AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070133511",
"telephone_number": "973-574-8060",
"fax_number": "973-574-8061"
}
],
"practiceLocations": [
{
"address_1": "89 Main St",
"address_purpose": "LOCATION",
"city": "Paterson",
"state": "NJ",
"postal_code": "07505",
"country_code": "US",
"telephone_number": "973-742-7880",
"fax_number": "973-247-0770",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOISES",
"first_name": "RODULFO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2019-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA6309900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.