NPIMap

Individual provider Active NPI

Brian A Moogerfeld, M.D.

  • Internal Medicine Physician
  • Statesboro, GA
National Provider Identifier
1235287004
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
051598 Issued in GA
Practice address
1088A Bermuda Run
Statesboro, GA 30458-0858
Phone
(912) 681-7111
Fax
(912) 871-7794
NPI assigned
Jan 8, 2007
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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 051598 GA Primary

Addresses

Primary practice location

1088A Bermuda Run
Statesboro, GA 30458-0858

Mailing address

1088A Bermuda Run
Statesboro, GA 30458-0858
Phone (912) 681-7111

Other identifiers 2

IdentifierTypeStateIssuer
594331017BMedicaidGA
594331017AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.moogerfeld.1@8824.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000872 GA Practitioner - Internal Medicine 3971405408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Georgia Hma Physician Management LLCGroup PAC ID 7214068592, 42 clinicians

Practice addresses (Care Compare)

1449 Brampton Ave
Statesboro, GA 30458-0854
Phone (912) 486-1163

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.68 of 100Reported as apm
Quality
76.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Georgia Hma Physician Management, LLC Internal Medicine CurrentSince Nov 1, 2020 Accepting new patients
Maria a Moogerfeld MD, LLC Internal Medicine Past Accepting new patients

Locations

1449 Brampton Ave
Statesboro, GA 30458
Phone (912) 486-1163

1497 Fair Rd
Ste 103
Statesboro, GA 30458
Phone (912) 486-1163

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

Interoperability endpoints

  • Direct secure messaging: brian.moogerfeld.1@8824.direct.athenahealth.com

Organizations & group practices 2

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 4

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1235287004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088A BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-681-7111",
            "fax_number": "912-871-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088A BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-681-7111",
            "fax_number": "912-871-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOGERFELD",
        "first_name": "BRIAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "594331017B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "594331017A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.moogerfeld.1@8824.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1449 Brampton Ave",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304580854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.