Individual provider Active NPI

Joseph Walter Moleski Jr., D.O.

  • Adult Medicine Physician
  • Fenton, MO
National Provider Identifier
1417337676
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
2017023056 Issued in MO
Practice address
1015 Bowles Ave
Fenton, MO 63026
Phone
(636) 496-2000
NPI assigned
Jun 3, 2015
Last updated
Nov 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2017023056 MO
Adult Medicine Physician 207QA0505X 2017023056 MO Primary

Addresses

Primary practice location

1015 Bowles Ave
Fenton, MO 63026

Mailing address

453 Amber Lake CT
Imperial, MO 63052-3114
Phone (314) 258-4812

Other practice location 1

6420 Clayton Rd Rm 2243
Saint Louis, MO 63117-1811
Phone (314) 951-7230

Other practice location 2

453 Amber Lake Ct
Imperial, MO 63052-3114
Phone (314) 258-4812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180521001605 MO Practitioner - Family PracticePractitioner - Hospitalist 5799087268 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Attigo Infusion Missouri LLCGroup PAC ID 5294139424, 5 clinicians

Practice addresses (Care Compare)

1585 Woodlake Dr
Chesterfield, MO 63017-5740
Phone (833) 696-3349

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Aug 21, 2019 Accepting new patients
Galen Inpatient Physicians PC. Hospitalist CurrentSince Oct 31, 2019 Accepting new patients
Yam Medical Center LLC CurrentSince May 1, 2022 Accepting new patients
Attigo Infusion Missouri LLC CurrentSince Jun 10, 2024 Accepting new patients
Dr. Petre I Anguelinin, LLC CurrentSince Jul 1, 2018 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Oct 31, 2019 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

12800 Boenker Ln
Bridgeton, MO 63044
Phone (314) 499-6060

1585 Woodlake Dr
Ste 200
Chesterfield, MO 63017
Phone (314) 434-7430

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1980 SE Blue Pkwy
Ste 302
Lees Summit, MO 64063

1520 N Church Rd
Ste D
Liberty, MO 64068

6420 Clayton Rd
Rm 2243
Saint Louis, MO 63117
Phone (314) 951-7230

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

1000 Des Peres Rd
Ste 220
Saint Louis, MO 63131

300 Saint Peters Centre Blvd
Ste 220
Saint Peters, MO 63376

15301 Spectrum Dr
Ste 330
Addison, TX 75001
Phone (806) 239-5716

Organizations & group practices 7

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": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1417337676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 AMBER LAKE CT",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630523114",
            "telephone_number": "314-258-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "63026",
            "telephone_number": "636-496-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6420 Clayton Rd Rm 2243",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171811",
            "country_code": "US",
            "telephone_number": "314-951-7230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "453 Amber Lake Ct",
            "address_purpose": "LOCATION",
            "city": "Imperial",
            "state": "MO",
            "postal_code": "630523114",
            "country_code": "US",
            "telephone_number": "314-258-4812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLESKI",
        "first_name": "JOSEPH",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2017023056",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MO",
            "license": "2017023056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.