Individual provider Active NPI

Michael G Moskovitz, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Stony Brook, NY
National Provider Identifier
1366857468
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
291377 Issued in NY
Practice address
100 Nicolls Road
HSC T16-020
Stony Brook, NY 11794
Phone
(631) 444-2292
NPI assigned
Jun 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 291377 NY
Internal Medicine Physician 207R00000X C1-0012476 DE
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 291377 NY Primary

Addresses

Primary practice location

100 Nicolls Road
HSC T16-020
Stony Brook, NY 11794

Mailing address

100 Nicolls Road
HSC T-16 020
Stony Brook, NY 11794
Phone (631) 444-2292

Other practice location 1

4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200
Phone (302) 623-0188

Other practice location 2

1275 York Ave
New York, NY 10065-6007
Phone (310) 753-5612

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
I20190329000856 NY Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 7719248582 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stony Brook Internists University Faculty Practice CorporationGroup PAC ID 9133019821, shared by 4 NPIs, 427 clinicians

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001

101 Nicolls Rd
Stony Brook, NY 11794-0001

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

PO Box
Suite 1554
Stony Brook, NY 11790-0989

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0012476DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Internal Medicine CurrentSince Dec 24, 2020 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 15, 2020 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 15, 2020 Accepting new patients
Memorial Medical Consultation Group Internal Medicine CurrentSince Feb 18, 2019 Accepting new patients

Locations

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794
Phone (631) 638-0800

100 Nicolls Rd
#T16202
Stony Brook, NY 11794

100 Nicolls Rd
#T16020
Stony Brook, NY 11794
Phone (631) 444-2292

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

100 Nicolls Rd
#T16
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: michael.moskovitz@direct.stonybrookmedicine.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1366857468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS ROAD",
            "address_2": "HSC T-16 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS ROAD",
            "address_2": "HSC T16-020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Road",
            "address_2": "Suite 5A43",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-623-0188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "310-753-5612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSKOVITZ",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "291377",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0012476",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "291377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.