Active NPI
Andrew Moshman
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1356767834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 057925
- Practice address
- 136 Kane St
Brooklyn, NY 11231-3037 - Phone
- (718) 625-4603
- NPI assigned
- Mar 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 057925 | NY | Primary |
Addresses
Primary practice location
136 Kane St
Brooklyn, NY 11231-3037
Mailing address
136 Kane St
Brooklyn, NY 11231-3037
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160615001769 | NY | Order and Referring Only - Dentist | 3870884224 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057925 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1356767834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 KANE ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112313037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 KANE ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112313037",
"telephone_number": "718-625-4603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSHMAN",
"first_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-08",
"last_updated": "2021-12-22",
"certification_date": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "057925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.