Individual provider Active NPI

Stavroula Moshos, O.D.

  • Optometrist
  • North Brunswick, NJ
National Provider Identifier
1255384152
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00603000 Issued in NJ
Practice address
979 Route 1 South Walmart Vision Center
North Brunswick, NJ 08902
Phone
(732) 545-0435
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00603000 NJ Primary
Optometrist 152W00000X TUV007016-1 NY

Addresses

Primary practice location

979 Route 1 South Walmart Vision Center
North Brunswick, NJ 08902

Mailing address

5 Grace Rd
East Brunswick, NJ 08816-2753
Phone (732) 991-4936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20060509000258 NJ Practitioner - Optometry 7113938960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

979 US Hwy 1
North Brunswick, NJ 08902-2712
Phone (732) 545-0435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007016-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stavroula Moshos, P.C. Optometrist CurrentSince Apr 10, 2006 Accepting new patients

Locations

979 US Highway 1
North Brunswick, NJ 08902
Phone (732) 545-0435

3400 Bergenline Ave
Union City, NJ 07087
Phone (201) 836-0888

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1255384152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GRACE RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162753",
            "telephone_number": "732-991-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 ROUTE 1 SOUTH WALMART VISION CENTER",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "08902",
            "telephone_number": "732-545-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHOS",
        "first_name": "STAVROULA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00603000",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007016-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.