Michael A Moffa, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

200991 Issued in NY

Practice address

Glacier Creek Office Park- BLDG II
6711 Towpath Rd., Suite 175
East Syracuse, NY 13057-9510

Phone

(315) 458-2211

Fax

(315) 452-9025

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Colorectal Surgery (Proctology)

Education

Medical College of Pennsylvania, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colon Rectal Associates of Central New York LLPGroup PAC ID 3577536531, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmoffa2386944@direct.trinity-health.org
• Direct secure messaging: drmoffa@colonrectal.medentdirect.com

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

• Colon Rectal Associates of Central New York, LLP

  • Surgery Physician
  • East Syracuse, NY
  • NPI 1730248022
  Medicare reassignment Care Compare group
• Intrepid Lane ASC, LLC

  dba Intrepid Lane Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Syracuse, NY
  • NPI 1184378846
  NPD (past)

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

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1225147002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GLACIER CREEK OFFICE PARK- BLDG II",
            "address_2": "6711 TOWPATH RD., SUITE 175",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579510",
            "telephone_number": "315-458-2211",
            "fax_number": "315-452-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GLACIER CREEK OFFICE PARK- BLDG II",
            "address_2": "6711 TOWPATH RD., SUITE 175",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579510",
            "telephone_number": "315-458-2211",
            "fax_number": "315-452-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFA",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "200991",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "200991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01945160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Miller, PHARM.D.
• Katherine Milliman
• Michael Mincolla, MC
• Mackenzie Paige Miner
• Michele E Misiaszek, ANP
• Saeed Mohammad, MD
• Alexandria Molinaro
• Stephanie Elizabeth Moltion, LPN
• Teresa S Monnet, C.N.P.
• Renee M Mooney, D.C.

• Colon & Rectal Surgery Physician in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Colon & Rectal Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.