Individual provider Active NPI

Moadh Masoud

  • Pharmacist
  • Madison, WI
National Provider Identifier
1205189792
Registry record updated Oct 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16755-40 Issued in WI
Practice address
6729 Pima Dr Apt 202
Madison, WI 53719-5669
Phone
(414) 840-4393
NPI assigned
Oct 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16755-40 WI Primary

Addresses

Primary practice location

6729 Pima Dr Apt 202
Madison, WI 53719-5669

Mailing address

6729 Pima Dr Apt 202
Madison, WI 53719-5669
Phone (414) 840-4393

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

State licenses

LicenseStateTypeSpecialty
16755-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350777600000",
    "number": "1205189792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6729 PIMA DR APT 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537195669",
            "telephone_number": "414-840-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6729 PIMA DR APT 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537195669",
            "telephone_number": "414-840-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOUD",
        "first_name": "MOADH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-21",
        "last_updated": "2012-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "16755-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2012; 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.