Individual provider Active NPI

Michael Gene Moeller, MD

  • Emergency Medicine Physician
  • Salinas, CA
National Provider Identifier
1184615403
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C39268 Issued in CA
Practice address
1441 Constition Blvd
Salinas, CA 93906
Phone
(831) 796-1603
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C39268 CA Primary

Addresses

Primary practice location

1441 Constition Blvd
Salinas, CA 93906

Mailing address

2100 Powell St Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2654

Other identifiers 2

IdentifierTypeStateIssuer
00C392680MedicaidCA
OOC392680OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070323000563 CA Practitioner - Emergency Medicine 4688657745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39268CAMDOrthodontics and Dentofacial Orthopedic Dentist
C39268CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Feb 1, 2007 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1184615403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 CONSTITION BLVD",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93906",
            "telephone_number": "831-796-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "MICHAEL",
        "middle_name": "GENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C39268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C392680",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OOC392680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.