Individual provider Active NPI

Juliana Bridget Moylan, M.D.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1366640286
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
244958 Issued in NY
Practice address
3400 Bainbridge Ave
8TH Floor
Bronx, NY 10467-2404
Phone
(718) 920-5161
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 244958 NY Primary

Addresses

Primary practice location

3400 Bainbridge Ave
8TH Floor
Bronx, NY 10467-2404

Mailing address

22 Cherry LN
Putnam Valley, NY 10579-2507
Phone (914) 714-8141

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070825000029 NY Practitioner - Pediatric Medicine 5890887541 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Jan 1, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Jan 1, 2012 Accepting new patients

Locations

2100 Bartow Ave
Bronx, NY 10475
Phone (718) 320-5300

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1366640286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHERRY LN",
            "city": "PUTNAM VALLEY",
            "state": "NY",
            "postal_code": "105792507",
            "telephone_number": "914-714-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "address_2": "8TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "JULIANA",
        "middle_name": "BRIDGET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "244958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.