Individual provider Active NPI

Kerry Lee Moseman, MD

  • Internal Medicine Physician
  • Reno, NV
National Provider Identifier
1225597008
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30217 Issued in NV
Practice address
6500 Longley LN
Reno, NV 89511-2632
Phone
(775) 799-7320
NPI assigned
Mar 19, 2019
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30217 NV Primary
Internal Medicine Physician 207R00000X 1503 CA

Addresses

Primary practice location

6500 Longley LN
Reno, NV 89511-2632

Mailing address

6500 Longley LN
Reno, NV 89511-2632
Phone (775) 352-5301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220819001796 CA Practitioner - Internal Medicine 6901289123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nevada School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
Santa Clara Vly Med
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1503CAMDDental Assistant
30217NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Internal Medicine Current Accepting new patients
County of Santa Clara CurrentSince Jun 26, 2025 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jun 26, 2025 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

5150 E Pacific Coast Hwy
Ste 500
Long Beach, CA 90804
Phone (562) 299-5200

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

750 S Bascom Ave
#1112
San Jose, CA 95128

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: kmoseman235010@santaclaravalley.direct-ci.net

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1225597008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112632",
            "telephone_number": "775-352-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112632",
            "telephone_number": "775-799-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSEMAN",
        "first_name": "KERRY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "30217",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "1503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.