Individual provider Active NPI

Moya I Martin, DO

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1336371129
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS11359 Issued in FL
Practice address
2247 Palm Beach Lakes Blvd Ste 204B
West Palm Beach, FL 33409-3409
Phone
(561) 766-0520
Fax
(561) 766-0521
NPI assigned
Aug 13, 2009
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS11359 FL Primary

Addresses

Primary practice location

2247 Palm Beach Lakes Blvd Ste 204B
West Palm Beach, FL 33409-3409

Mailing address

2247 Palm Beach Lakes Blvd Ste 204B
West Palm Beach, FL 33409-3409
Phone (561) 766-0520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110822000291 FL Practitioner - Family Practice 4082884473

National Provider Directory

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

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": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1336371129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 PALM BEACH LAKES BLVD STE 204B",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093409",
            "telephone_number": "561-766-0520",
            "fax_number": "561-766-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2247 PALM BEACH LAKES BLVD STE 204B",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093409",
            "telephone_number": "561-766-0520",
            "fax_number": "561-766-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MOYA",
        "middle_name": "I",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.