Individual provider Active NPI

Marie Evelyne Moise, M.D.

  • Internal Medicine Physician
  • Coral Springs, FL
National Provider Identifier
1225072804
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0065467 Issued in FL
Practice address
9900 W Sample Rd
Coral Springs, FL 33065-4048
Phone
(954) 575-4940
NPI assigned
Jun 15, 2006
Last updated
Aug 31, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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 ME0065467 FL Primary

Addresses

Primary practice location

9900 W Sample Rd
Coral Springs, FL 33065-4048

Mailing address

1050 Wilshire Cir W
Pembroke Pines, FL 33027-2200
Phone (954) 438-4489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110124000458 FL Practitioner - Internal Medicine 8426237439 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0065467FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jul 1, 2015 Accepting new patients
South Broward Hospital District CurrentSince Jul 1, 2015 Accepting new patients
South Broward Hospital District Current Accepting new patients

Locations

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

6730 Miramar Pkwy
Miramar, FL 33023
Phone (954) 276-6600

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1225072804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 WILSHIRE CIR W",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330272200",
            "telephone_number": "954-438-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654048",
            "telephone_number": "954-575-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISE",
        "first_name": "MARIE EVELYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0065467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.