Individual provider Active NPI

Teresa Moll, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, MS
National Provider Identifier
1285096396
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
27609 Issued in MS
Practice address
2500 N State St
Department of Medicine
Jackson, MS 39216-4500
Phone
(601) 984-5532
Fax
(601) 984-6665
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 27609 MS Primary

Addresses

Primary practice location

2500 N State St
Department of Medicine
Jackson, MS 39216-4500

Mailing address

2500 N State St
Department of Medicine
Jackson, MS 39216-4500
Phone (601) 984-5532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220908003484 MS Practitioner - Internal Medicine 5597057257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001
  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2022 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2022 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

1010 Lakeland Pl
Flowood, MS 39232
Phone (601) 815-0600

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1410 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: tmoll9328@ummc.direct-ci.com

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 3

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1285096396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5532",
            "fax_number": "601-984-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5532",
            "fax_number": "601-984-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLL",
        "first_name": "TERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "27609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.