NPIMap

Individual provider Active NPI

Marcus Moseley, D.O.

  • Vascular Surgery Physician
  • Owensboro, KY
National Provider Identifier
1265815898
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
04738 Issued in KY
Practice address
2801 New Hartford Rd
Owensboro, KY 42303-1320
Phone
(270) 683-3720
Fax
(270) 686-7331
NPI assigned
Jul 1, 2015
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101021877 MI
Surgery Physician 208600000X 04738 KY
Vascular Surgery Physician 2086S0129X 04738 KY Primary

Addresses

Primary practice location

2801 New Hartford Rd
Owensboro, KY 42303-1320

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

910 Wallace Ave Ste 206
Leitchfield, KY 42754-2408
Phone (270) 259-3035

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoseley117557@direct.owensborohealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220809003617 KY Practitioner - Vascular SurgeryPractitioner - General Surgery 7416260880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

2211 Mayfair Dr
Owensboro, KY 42301-4569

2801 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 683-3720

2885 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 685-2374

910 Wallace Ave
Leitchfield, KY 42754-2408

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9491

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)39
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Surgery Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Aug 1, 2022 Accepting new patients
Owensboro Health Medical Group, Inc Surgery CurrentSince Aug 1, 2022 Accepting new patients
Owensboro Health Inc Past Accepting new patients
Owensboro Health Medical Group, Inc Past Accepting new patients

Locations

910 Wallace Ave
Ste 206
Leitchfield, KY 42754
Phone (270) 259-3035

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

2801 New Hartford Rd
Owensboro, KY 42303
Phone (270) 683-3720

Interoperability endpoints

  • Direct secure messaging: mmoseley117557@direct.owensborohealth.org

Organizations & group practices 5

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 7

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1265815898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NEW HARTFORD RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-683-3720",
            "fax_number": "270-686-7331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Wallace Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Leitchfield",
            "state": "KY",
            "postal_code": "427542408",
            "country_code": "US",
            "telephone_number": "270-259-3035",
            "fax_number": "270-259-3332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "MARCUS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101021877",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "04738",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KY",
            "license": "04738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoseley117557@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "2801 New Hartford Rd",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423031320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.