Individual provider Active NPI

Leonard J Moss, D.O.

  • Cardiovascular Disease Physician
  • Cedar Knolls, NJ
National Provider Identifier
1417988262
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MB05531200 Issued in NJ
Practice address
11 Saddle Rd
Cedar Knolls, NJ 07927-1901
Phone
(973) 267-2122
Fax
(973) 292-1466
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MB05531200 NJ Primary

Addresses

Primary practice location

11 Saddle Rd
Cedar Knolls, NJ 07927-1901

Mailing address

PO Box 416457
Boston, MA 02241-6457

Other identifiers 1

IdentifierTypeStateIssuer
7291906MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20101122001189 NJ Practitioner - Cardiovascular Disease (Cardiology) 0749189470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians
Cardiovascular Health Consultants, P.a.Group PAC ID 8325934706, 118 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

11 Saddle Rd
Cedar Knolls, NJ 07927-1901
Phone (973) 267-2122

333 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone (973) 895-6601

95 Madison Ave
Suite 204
Morristown, NJ 07960-6390
Phone (973) 971-7440

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Health Consultants, P.a. CurrentSince May 1, 2016 Accepting new patients
Practice Associates Medical Group CurrentSince Sep 25, 2011 Accepting new patients

Locations

11 Saddle Rd
Cedar Knolls, NJ 07927
Phone (973) 267-2122

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1417988262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SADDLE RD",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271901",
            "telephone_number": "973-267-2122",
            "fax_number": "973-292-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "LEONARD",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MB05531200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7291906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

Verify at the official NPI Registry.