Individual provider Active NPI

James A. Moody, MD

  • Neurological Surgery Physician
  • Dallas, TX
National Provider Identifier
1417093329
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
D9576 Issued in TX
Practice address
1411 N Beckley Ave
Pav III Ste#152
Dallas, TX 75203-1259
Phone
(214) 948-2076
Fax
(214) 948-9990
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X D9576 TX Primary

Addresses

Primary practice location

1411 N Beckley Ave
Pav III Ste#152
Dallas, TX 75203-1259

Mailing address

1411 N Beckley Ave
Pav III Ste#152
Dallas, TX 75203-1259
Phone (214) 948-2076

Other identifiers 2

IdentifierTypeStateIssuer
120187305MedicaidTX
8AE104OtherTXBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080605000603 TX Practitioner - Neurosurgery 8527138320 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D9576TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince May 1, 2008 Accepting new patients
Medhealth CurrentSince May 1, 2008 Accepting new patients
Texas Neuro Spine Institute, PA Neurological Surgery Past Accepting new patients
Clinical Neurological Associates of Dallas, LLP Neurological Surgery Past Accepting new patients

Locations

221 W Colorado Blvd
Ste 155
Dallas, TX 75208
Phone (214) 393-5007

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

1411 N Beckley Ave
Ste 152
Dallas, TX 75203
Phone 2149487700208

221 W Colorado Blvd
#155
Dallas, TX 75208
Phone (214) 941-7724

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDBGCA

Organizations & group practices 4

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1417093329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "PAV III STE#152",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031259",
            "telephone_number": "214-948-2076",
            "fax_number": "214-948-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "PAV III STE#152",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031259",
            "telephone_number": "214-948-2076",
            "fax_number": "214-948-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JAMES",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "D9576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120187305",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8AE104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.