Individual provider Active NPI

Tamara Annell Moseley, DPM

  • Podiatrist
  • San Angelo, TX
National Provider Identifier
1245676469
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2057 Issued in TX
Practice address
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone
(325) 658-1511
NPI assigned
May 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2057 TX Primary

Addresses

Primary practice location

3555 Knickerbocker Rd
San Angelo, TX 76904-7610

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-4939

Other identifiers 1

IdentifierTypeStateIssuer
2057OtherTXSTATE BOARD OF PODIATRIC MEDICAL EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130830000724 TX Practitioner - Podiatry 1759524218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dora Roberts Rehabilitation CenterGroup PAC ID 0941285498, 114 clinicians
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

306 W 3Rd St
Big Spring, TX 79720-2429
Phone (432) 267-3806

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-1511

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Jun 15, 2022 Accepting new patients
Moseley Chiropractic and Wellness Center PLLC PastSince Feb 12, 2023 Accepting new patients

Locations

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1245676469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-658-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "TAMARA",
        "middle_name": "ANNELL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2022-07-15",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "2057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PODIATRIC MEDICAL EXAMINERS",
            "identifier": "2057",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.