Individual provider Active NPI

Robert P Moser Jr., M.D.

  • Family Medicine Physician
  • Great Bend, KS
National Provider Identifier
1235241779
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-21464 Issued in KS
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 603-7398
Fax
(620) 796-2274
NPI assigned
Aug 31, 2006
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-21464 KS Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 04-21464 KS

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

1809 E 27TH St
Hays, KS 67601-2148
Phone (785) 621-6556

Other practice location 1

1809 E 27th St
Hays, KS 67601-2148
Phone (785) 621-6556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20050613001105 KS Practitioner - Family Practice 1052355856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ukhs Great Bend LLCGroup PAC ID 5597016378, 64 clinicians

Practice addresses (Care Compare)

514 Cleveland St
Great Bend, KS 67530-3562
Phone (620) 792-8833

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-21464KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ukhs Great Bend, LLC Family Medicine CurrentSince Mar 18, 2019 Accepting new patients
Greeley County Health Services, Inc Past Accepting new patients
Greeley County Health Services Inc Past Accepting new patients
Mid-America Cardiology Associates, Inc. Past Accepting new patients
Hamilton County Hospital Past Accepting new patients
University of Kansas School of Medicine Wichita Medical Practice Assoc Family Medicine PastSince Jan 1, 1999 Accepting new patients

Locations

3515 Broadway Ave
Great Bend, KS 67530
Phone (620) 786-6163

514 Cleveland St
Great Bend, KS 67530
Phone (620) 659-2890

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/greelco-fe371fba

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1235241779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 E 27TH ST",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012148",
            "telephone_number": "785-621-6556",
            "fax_number": "857-621-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-603-7398",
            "fax_number": "620-796-2274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1809 E 27th St",
            "address_purpose": "LOCATION",
            "city": "Hays",
            "state": "KS",
            "postal_code": "676012148",
            "country_code": "US",
            "telephone_number": "785-621-6556",
            "fax_number": "785-621-4164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSER",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-21464",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "KS",
            "license": "04-21464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.