Mallory A Moebs, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

352794 Issued in NY

Practice address

3401 Orchard Park Rd Ste C
Orchard Park, NY 14067-9274

Phone

(716) 674-3104

Fax

(716) 674-0666

NPI assigned

Sep 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1376320390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8276 MILL RD",
            "city": "GASPORT",
            "state": "NY",
            "postal_code": "140679274",
            "telephone_number": "716-417-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 ORCHARD PARK RD STE C",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "140679274",
            "telephone_number": "716-674-3104",
            "fax_number": "716-674-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEBS",
        "first_name": "MALLORY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2024-04-25",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Mischel
• Laura Wellington Miskell, M.S.,CCC-SLP
• Rhianna Paige Mitchell, OTR/L
• Zachary Mitchell
• Elizabeth Mobley, MSCCC/SLP
• Ellen Healy Mogavero, MS,CCC/SLP
• Mary Jude Mogavero
• Wilfrido D. Mojica, MD
• Julie Christine Moll, MSW
• Joseph John Monaco

• Family Nurse Practitioner in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.

Verify at the official NPI Registry.