Mark Moss, PH.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

3324 Issued in MA

Practice address

720 Harrison Ave
Suite 707
Boston, MA 02118-2371

Phone

(617) 638-8456

Fax

(617) 638-8465

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1174586382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "SUITE 707",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-638-8456",
            "fax_number": "617-638-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "SUITE 707",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-638-8456",
            "fax_number": "617-638-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "MARK",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "3324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0516554",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Russell Moss, MD
• Gary Moss, OD
• Julia Elizabeth Moss, MD
• Kassie Lyn Moss
• Laura Moss
• Mary Elizabeth Moss, MD, PHD
• Mellisa Moss
• Roy L Moss, M.D.
• Matthew Mossanen, M.D.
• Matthew Mossayebi, MD, MPH

• Neurology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.