Individual provider Active NPI

Max Greger-Moser, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1295136455
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12.005770 Issued in CT
Practice address
184 Liberty St
New Haven, CT 06519-1625
Phone
(203) 688-9711
NPI assigned
Sep 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12.005770 CT Primary

Addresses

Primary practice location

184 Liberty St
New Haven, CT 06519-1625

Mailing address

20 York St
New Haven, CT 06511-4916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141117001049 CT Practitioner - Nurse Practitioner 8022230556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMS Neurohealth PLLCGroup PAC ID 7719216548, 6 clinicians

Practice addresses (Care Compare)

64 Thompson St
Suite A105
East Haven, CT 06513-5700
Phone 20368092352815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5770CTMDAddiction (Substance Use Disorder) Counselor
12.005770CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMS Neurohealth PLLC CurrentSince Dec 28, 2021 Accepting new patients

Locations

64 Thompson St
Ste A105
East Haven, CT 06513
Phone (203) 635-8350

140 Sherman St
Ste 5
Fairfield, CT 06824

901 Farmington Ave
Ste 300
West Hartford, CT 06119

836 Farmington Ave
Ste 109
West Hartford, CT 06119
Phone (203) 691-1685

Organizations & group practices 2

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": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1295136455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 LIBERTY ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191625",
            "telephone_number": "203-688-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGER-MOSER",
        "first_name": "MAX",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.005770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.