Individual provider Active NPI

Mojdeh Momeni, M.D.

  • Gastroenterology Physician
  • Poughkeepsie, NY
National Provider Identifier
1235396714
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
230985 Issued in NY
Practice address
159 Barnegat Rd FL 2
Poughkeepsie, NY 12601-5401
Phone
(845) 452-9800
Fax
(845) 452-7691
NPI assigned
May 21, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 230985 NY Primary

Addresses

Primary practice location

159 Barnegat Rd FL 2
Poughkeepsie, NY 12601-5401

Mailing address

111 Clock Tower CMNS
Brewster, NY 10509-4055
Phone (845) 592-4915

Other practice location 1

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-6945

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041105000032 NY Practitioner - Internal MedicinePractitioner - Gastroenterology 1052374600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

222 Westchester Ave
Suite 101
White Plains, NY 10604-2923
Phone (914) 946-1010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy124
Upper gastrointestinal (GI) endoscopy for acid reflux118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230985NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Physician Services PC CurrentSince Feb 1, 2023 Accepting new patients
Poughkeepsie Medical Group LLP CurrentSince Dec 1, 2014 Accepting new patients
Nuvance Health Medical Practice PC PastSince Jul 24, 2022 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients

Locations

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

375 Hooker Ave
Poughkeepsie, NY 12603
Phone (845) 454-5000

222 Westchester Ave
Ste 101
White Plains, NY 10604
Phone 9149461010324

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mmomeni@direct.health-quest.org

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235396714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CLOCK TOWER CMNS",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094055",
            "telephone_number": "845-592-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BARNEGAT RD FL 2",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015401",
            "telephone_number": "845-452-9800",
            "fax_number": "845-452-7691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Dekalb Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112015425",
            "country_code": "US",
            "telephone_number": "718-250-6945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMENI",
        "first_name": "MOJDEH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "230985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.