Individual provider Active NPI

John L Moseri, MD

  • Addiction Psychiatry Physician
  • Decatur, GA
National Provider Identifier
1346253309
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
041344 Issued in GA
Practice address
1810 Moseri Rd
Decatur, GA 30032-5116
Phone
(404) 289-8223
Fax
(404) 289-8224
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 041344 GA Primary

Addresses

Primary practice location

1810 Moseri Rd
Decatur, GA 30032-5116

Mailing address

1810 Moseri Rd
Decatur, GA 30032-5116
Phone (404) 289-8223

Other identifiers 1

IdentifierTypeStateIssuer
000899929AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@nibhinc.com Newport Integrated Behavioral Healthcare, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100817001134 GA Practitioner - PsychiatryPractitioner - Addiction Medicine 1254434400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1810 Moseri Rd
Decatur, GA 30032-5116
Phone (404) 289-8223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041344GAMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Integrated Behavioral Healthcare, Inc CurrentSince Feb 14, 2007 Accepting new patients

Locations

1810 Moseri Rd
Decatur, GA 30032
Phone (404) 289-8223

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1346253309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MOSERI RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325116",
            "telephone_number": "404-289-8223",
            "fax_number": "404-289-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MOSERI RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325116",
            "telephone_number": "404-289-8223",
            "fax_number": "404-289-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSERI",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "GA",
            "license": "041344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000899929A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@nibhinc.com",
            "affiliation": "Y",
            "affiliationName": "Newport Integrated Behavioral Healthcare, Inc",
            "address_1": "1810 Moseri Rd",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300325116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.