Moya Tara Talley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704327517 Issued in MI

Practice address

25140 Austin Dr
New Boston, MI 48164-8907

Phone

(313) 461-5780

NPI assigned

May 21, 2016

Last updated

Aug 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MynaGroup PAC ID 6406257310, 2 clinicians

Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myna

  • Urgent Care Clinic/Center
  • Inkster, MI
  • NPI 1396351037
  Medicare reassignment Care Compare group NPD
• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  MI

  Medicare reassignment Care Compare group NPD
• MTT FNP LLC

  • Family Nurse Practitioner
  • New Boston, MI
  • NPI 1225626948
  Medicare reassignment Authorized official
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Eon Care Clinicians PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1073332490

  MI

  Medicare reassignment
• Wings of Angel Home Health Care, LLC

  • Home Health Agency
  • Southfield, MI
  • NPI 1619030251
  NPD (past)

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

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1194172981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25140 AUSTIN DR",
            "city": "NEW BOSTON",
            "state": "MI",
            "postal_code": "481648907",
            "telephone_number": "313-461-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25140 AUSTIN DR",
            "city": "NEW BOSTON",
            "state": "MI",
            "postal_code": "481648907",
            "telephone_number": "313-461-5780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4941 Heather Dr # C208",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481264135",
            "country_code": "US",
            "telephone_number": "313-461-5780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "MOYA",
        "middle_name": "TARA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-21",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704327517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in New Boston, MI
• Providers in New Boston, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.