Individual provider Active NPI

David M Moss, D.P.M.

  • Podiatrist
  • Garden City, MI
National Provider Identifier
1235185414
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
001094 Issued in MI
Practice address
27501 Warren Rd
Garden City, MI 48135-2253
Phone
(734) 427-7111
Fax
(734) 427-1377
NPI assigned
May 26, 2006
Last updated
Apr 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 001094 MI Primary

Addresses

Primary practice location

27501 Warren Rd
Garden City, MI 48135-2253

Mailing address

27501 Warren Rd
Garden City, MI 48135-2253
Phone (734) 427-7111

Other identifiers 5

IdentifierTypeStateIssuer
300294762OtherPPOM
5825121OtherMIBCBSM
480002353OtherTHE TRAVELERS RRM
5188247OtherAETNA
200000000910OtherFIDELIS SECURE CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040203000159 MI Practitioner - Podiatry 1254224538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27501 Warren Rd
Garden City, MI 48135-2253
Phone (734) 427-7111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions192
Removal of nail tissue222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001094MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Moss Foot Clinic PLLC Podiatrist CurrentSince Mar 17, 2008 Accepting new patients

Locations

27501 Warren Rd
Garden City, MI 48135
Phone (313) 427-7111

Organizations & group practices 1

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1235185414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27501 WARREN RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352253",
            "telephone_number": "734-427-7111",
            "fax_number": "734-427-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27501 WARREN RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352253",
            "telephone_number": "734-427-7111",
            "fax_number": "734-427-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "001094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "300294762",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "5825121",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE TRAVELERS RRM",
            "identifier": "480002353",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5188247",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS SECURE CARE",
            "identifier": "200000000910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.