Individual provider Active NPI

Peter M Moy, MD

  • Vascular Surgery Physician
  • Virginia Beach, VA
National Provider Identifier
1427020403
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101051511 Issued in VA
Practice address
397 Little Neck Rd, 3300 South BLDG
Suite 100
Virginia Beach, VA 23452
Phone
(757) 470-5570
Fax
(757) 227-3377
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 59179 AZ
Vascular Surgery Physician 2086S0129X 0101051511 VA Primary

Addresses

Primary practice location

397 Little Neck Rd, 3300 South BLDG
Suite 100
Virginia Beach, VA 23452

Mailing address

397 Little Neck Rd
Suite 100
Virginia Beach, VA 23452-5765
Phone (757) 470-5570

Other practice location 1

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 773-2200

Other identifiers 2

IdentifierTypeStateIssuer
007313837MedicaidVA
020054467OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, SD, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080331000410 VA Practitioner - Vascular Surgery 2264412998 Reassigns benefits to 1 organization
I20170510001407 SD Practitioner - Thoracic Surgery 2264412998 Reassigns benefits to 1 organization
I20190913001104 AZ Practitioner - Vascular Surgery 2264412998 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1655SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jun 21, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Apr 14, 2017 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jun 21, 2021 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Aug 1, 2019 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Apr 14, 2017 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Mandell Retina Center PC Past Accepting new patients

Locations

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Interoperability endpoints

  • Direct secure messaging: pmoy2730@direct.sentara.net

Organizations & group practices 8

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1427020403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 LITTLE NECK RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234525765",
            "telephone_number": "757-470-5570",
            "fax_number": "757-227-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 LITTLE NECK RD, 3300 SOUTH BLDG",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23452",
            "telephone_number": "757-470-5570",
            "fax_number": "757-227-3377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Beaver St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860013118",
            "country_code": "US",
            "telephone_number": "928-773-2200",
            "fax_number": "928-773-2151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOY",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "59179",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101051511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007313837",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "020054467",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.