Individual provider Active NPI

Monireh Moghaddam, DC

  • Chiropractor
  • Friendswood, TX
National Provider Identifier
1417995150
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9236 Issued in TX
Practice address
700 S Friendswood Dr
Suite E
Friendswood, TX 77546-4581
Phone
(281) 993-9100
Fax
(281) 482-0750
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9236 TX Primary

Addresses

Primary practice location

700 S Friendswood Dr
Suite E
Friendswood, TX 77546-4581

Mailing address

700 S Friendswood Dr
Suite E
Friendswood, TX 77546-4581
Phone (281) 993-9100

Other identifiers 1

IdentifierTypeStateIssuer
157280201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100713000062 TX Practitioner - Chiropractic 0840322756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 S Friendswood Dr
Suite 101
Friendswood, TX 77546-5095
Phone (281) 993-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9236TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Friendswood Family Chiropractic Clinic, PLLC Chiropractor CurrentSince Jun 15, 2002 Accepting new patients

Locations

1111 S Friendswood Dr
Ste 101
Friendswood, TX 77546
Phone (281) 993-9100

700 S Friendswood Dr
Ste E
Friendswood, TX 77546
Phone (281) 993-9100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1417995150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S FRIENDSWOOD DR",
            "address_2": "SUITE E",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775464581",
            "telephone_number": "281-993-9100",
            "fax_number": "281-482-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S FRIENDSWOOD DR",
            "address_2": "SUITE E",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775464581",
            "telephone_number": "281-993-9100",
            "fax_number": "281-482-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAM",
        "first_name": "MONIREH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157280201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendswood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.