Individual provider Active NPI

Thomas E Moskow, MD

  • Pediatrics Physician
  • Topeka, KS
National Provider Identifier
1407892771
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04-31434 Issued in KS
Practice address
4100 SW 15TH St
Topeka, KS 66604-4333
Phone
(785) 273-7871
NPI assigned
Jun 22, 2006
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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 04-31434 KS Primary

Addresses

Primary practice location

4100 SW 15TH St
Topeka, KS 66604-4333

Mailing address

4100 SW 15TH St
Topeka, KS 66604-4333
Phone (785) 273-7871

Other identifiers 3

IdentifierTypeStateIssuer
30004009410002MedicaidKS
200331230AMedicaidKS
KA2129009OtherKSMEDICARE PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tmoskow7278@stormontvaildirect.org Direct COTTON O'NEIL CLINIC REVOCABLE TRUST
Direct Messaging Address tmoskow7278@stormontvaildirect.org Direct STORMONT-VAIL HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20110405001041 KS Practitioner - Pediatric Medicine 7618151291 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-31434KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Dec 22, 2021 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Dec 22, 2021 Accepting new patients
Jayhawk Pharmacy Services at Mission Woods Inc Past Accepting new patients

Locations

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

4100 SW 15th St
Topeka, KS 66604
Phone (785) 273-7871

901 SW Garfield Ave
Topeka, KS 66606

Interoperability endpoints

  • Direct secure messaging: tmoskow7278@stormontvaildirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1407892771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 SW 15TH ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666044333",
            "telephone_number": "785-273-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SW 15TH ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666044333",
            "telephone_number": "785-273-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKOW",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-31434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004009410002",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331230A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA2129009",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmoskow7278@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "COTTON O'NEIL CLINIC REVOCABLE TRUST",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4100 SW 15th St",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666044333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmoskow7278@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "STORMONT-VAIL HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4100 SW 15th St",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666044333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.