Organization Active NPI

Shuban K Moza MD PC

  • Surgery Physician
  • Rome, NY
National Provider Identifier
1346370871
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SHUBAN K MOZA MD PC
Practice address
1614 N James St
Rome, NY 13440
Phone
(315) 336-0565
Fax
(315) 337-6533
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shuban Kishen Moza, MD
Title
Pres Ceo
Phone
(315) 336-0565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1614 N James St
Rome, NY 13440

Mailing address

1614 N James St
Rome, NY 13440
Phone (315) 336-0565

Other names 1

  • Shuban K Moza MD Prof Corp Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346370871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 N JAMES ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13440",
            "telephone_number": "315-336-0565",
            "fax_number": "315-337-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 N JAMES ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13440",
            "telephone_number": "315-336-0565",
            "fax_number": "315-337-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUBAN K MOZA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOZA",
        "authorized_official_first_name": "SHUBAN",
        "authorized_official_middle_name": "KISHEN",
        "authorized_official_title_or_position": "PRES CEO",
        "authorized_official_telephone_number": "315-336-0565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shuban K Moza MD Prof Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.