Individual provider Active NPI

Hershel S. Moss, M.D.

  • Emergency Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1407920911
Registry record updated Mar 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
046203 Issued in MI
Practice address
4008 Calgary CT
Ann Arbor, MI 48108-2798
Phone
(734) 668-6462
Fax
(734) 369-3369
NPI assigned
Nov 17, 2006
Last updated
Mar 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 046203 MI Primary

Addresses

Primary practice location

4008 Calgary CT
Ann Arbor, MI 48108-2798

Mailing address

4008 Calgary CT
Ann Arbor, MI 48108-2798
Phone (734) 668-6462

Other identifiers 4

IdentifierTypeStateIssuer
HM046203OtherCOMMERCIAL-COMMERCIAL NUMBER
010H262530OtherBLUE CROSS-BLUE CROSS
424098110MedicaidMI
HM046203OtherCHAMPUS-CHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046203MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Ratliff-Moss LMSW, LLC Past Accepting new patients
McEwan Emergency Physicians Emergency Medicine Past Accepting new patients

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, 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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237680000000",
    "number": "1407920911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 CALGARY CT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082798",
            "telephone_number": "734-668-6462",
            "fax_number": "734-369-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 CALGARY CT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082798",
            "telephone_number": "734-668-6462",
            "fax_number": "734-369-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "HERSHEL",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "046203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "HM046203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "010H262530",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424098110",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "HM046203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.