Kenneth P Moffat, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

MD0000021088 Issued in TN

Practice address

345 23Rd Ave N
Suite 350
Nashville, TN 37203-1596

Phone

(615) 983-6000

Fax

(615) 983-6010

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Wesley & Klippenstein, PC

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Nashville, TN
  • NPI 1023025475
  NPD
• Retina Consultants of Nashville

  • Ophthalmology Physician
  • Hendersonville, TN
  • NPI 1104984780
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1215926126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 23RD AVE N",
            "address_2": "SUITE 350",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031596",
            "telephone_number": "615-983-6000",
            "fax_number": "615-983-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 23RD AVE N",
            "address_2": "SUITE 350",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031596",
            "telephone_number": "615-983-6000",
            "fax_number": "615-983-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFAT",
        "first_name": "KENNETH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD0000021088",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "28160",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "KY",
            "license": "28160",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "MD0000021088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/GROUP",
            "identifier": "3379053",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/GROUP",
            "identifier": "00554",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64798374",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Modahl, RN
• Modern Healing Collective PLLC
• Michael Terrance Modic, M.D.
• Kayvon Modjarrad, M.D., PH.D.
• Caylin Cervetti Moen
• Soroush Moghaddam
• Nazanin Moghbeli, MD
• Idil Mohamed
• Miriam Ramadhan Mohammad, PHARMD
• Mohammaddyab Saleh Mohammad, BBA

• Retina Specialist (Ophthalmology) Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Retina Specialist (Ophthalmology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.