NPIMap

Individual provider Active NPI

Peter Moll, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1265675607
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01072203A Issued in IN
Practice address
4725 Statesmen Dr
Ste C-D
Indianapolis, IN 46250-5644
Phone
(317) 577-4200
Fax
(317) 614-9655
NPI assigned
Apr 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01072203A IN Primary

Addresses

Primary practice location

4725 Statesmen Dr
Ste C-D
Indianapolis, IN 46250-5644

Mailing address

PO Box 7232-Dept 118
Indianapolis, IN 46207-7232
Phone (317) 614-9850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150807014911 NY Practitioner - Anesthesiology 1254575004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York at Stony Brook, School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01072203AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Anesthesiology Current Accepting new patients
Albany Medical College Anesthesiology CurrentSince Jun 1, 2015 Accepting new patients
Albany Medical College Anesthesiology CurrentSince May 1, 2019 Accepting new patients
Albany Medical College CurrentSince Jun 1, 2015 Accepting new patients
Albany Medical College Current Accepting new patients
Anesthesia Consultants of Indianapolis, LLC Anesthesiology Past Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#131
Albany, NY 12208
Phone (518) 262-4300

Interoperability endpoints

  • Direct secure messaging: pmoll100955@albanymed.direct-ci.com

Organizations & group practices 7

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1265675607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7232-DEPT 118",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462077232",
            "telephone_number": "317-614-9850",
            "fax_number": "800-731-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 STATESMEN DR",
            "address_2": "STE C-D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505644",
            "telephone_number": "317-577-4200",
            "fax_number": "317-614-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLL",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01072203A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.