Individual provider Active NPI

David Moreno, M.D

  • Internal Medicine Physician
  • Brooksville, FL
National Provider Identifier
1225045156
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME83919 Issued in FL
Practice address
12142 Cortez Blvd
Brooksville, FL 34613-5575
Phone
(352) 596-9095
Fax
(352) 578-1032
NPI assigned
Aug 2, 2006
Last updated
Apr 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME83919 FL Primary

Addresses

Primary practice location

12142 Cortez Blvd
Brooksville, FL 34613-5575

Mailing address

12142 Cortez Blvd
Brooksville, FL 34613-5575
Phone (352) 596-9095

Other practice location 1

12148 Cortez Blvd
Brooksville, FL 34613-5575
Phone (352) 596-9095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110510000229 FL Practitioner - Internal Medicine 8426100892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12142 Cortez Blvd
Brooksville, FL 34613-5575
Phone (352) 596-9095

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Age Medical Center Internal Medicine CurrentSince Aug 1, 2003 Accepting new patients
HC Medical Group, Inc CurrentSince Aug 1, 2012 Accepting new patients
Hernando Family Practice Center Inc Past Accepting new patients
Mulberry Oriental Medicine PastSince Aug 1, 2012 Accepting new patients

Locations

12142 Cortez Blvd
Brooksville, FL 34613
Phone (352) 596-1500

12148 Cortez Blvd
Spring Hill, FL 34613
Phone (352) 596-9095

910 Old Camp Rd
Ste 164
The Villages, FL 32162
Phone (352) 430-2720

910 Old Camp Rd
Ste 192
The Villages, FL 32162
Phone (352) 430-2720

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAJHDD/Endpoint/AAJHDD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1225045156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12142 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135575",
            "telephone_number": "352-596-9095",
            "fax_number": "352-578-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12142 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135575",
            "telephone_number": "352-596-9095",
            "fax_number": "352-578-1032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12148 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346135575",
            "country_code": "US",
            "telephone_number": "352-596-9095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME83919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.