Individual provider Active NPI

Jeffrey Marc Moscow, D.C.

  • Chiropractor
  • Largo, FL
National Provider Identifier
1316947955
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8809 Issued in FL
Practice address
2200 W Bay Dr
Largo, FL 33770-1929
Phone
(727) 518-2977
Fax
(727) 518-0010
NPI assigned
Jul 26, 2005
Last updated
Sep 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8809 FL Primary

Addresses

Primary practice location

2200 W Bay Dr
Largo, FL 33770-1929

Mailing address

2200 W Bay Dr
Largo, FL 33770-1929
Phone (727) 518-2977

Other identifiers 1

IdentifierTypeStateIssuer
381875600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000504 FL Practitioner - Chiropractic 7012960206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moscow Chiropractic LLCGroup PAC ID 3476506668, 2 clinicians

Practice addresses (Care Compare)

3277 Fruitville Rd
Unit A2
Sarasota, FL 34237-6410
Phone (941) 954-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8809FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Moscow Chiropractic LLC. Chiropractor CurrentSince Feb 10, 2019 Accepting new patients

Locations

1071 S Tuttle Ave
Ste 1
Sarasota, FL 34237
Phone (904) 951-3700

3277 Fruitville Rd
#A2
Sarasota, FL 34237
Phone (941) 500-2736

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1316947955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337701929",
            "telephone_number": "727-518-2977",
            "fax_number": "727-518-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337701929",
            "telephone_number": "727-518-2977",
            "fax_number": "727-518-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCOW",
        "first_name": "JEFFREY",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381875600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.