NPIMap

Individual provider Active NPI

Roberto A. Moraleda, M.D.

  • Internal Medicine Physician
  • Devils Lake, ND
National Provider Identifier
1427057231
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7501 Issued in ND
Practice address
1001 7TH St NE
Devils Lake, ND 58301-2719
Phone
(701) 662-2157
Fax
(701) 662-4116
NPI assigned
Jul 14, 2005
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7501 ND Primary

Addresses

Primary practice location

1001 7TH St NE
Devils Lake, ND 58301-2719

Mailing address

PO Box 1100
Devils Lake, ND 58301-1100
Phone (701) 662-2157

Other identifiers 1

IdentifierTypeStateIssuer
18843MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110330000340 ND Practitioner - Internal Medicine 4183721525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pacific University - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1001 7TH St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Internal Medicine Current Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Dec 1, 2014 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Dec 1, 2014 Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients
Lake Region Lutheran Home, Inc. Past Accepting new patients

Locations

3290 Solutions Ctr
Chicago, IL 60677

201 E 3rd Ave S
Cavalier, ND 58220
Phone (701) 265-8338

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

Organizations & group practices 5

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.

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1427057231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583011100",
            "telephone_number": "701-662-2157",
            "fax_number": "701-662-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 7TH ST NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012719",
            "telephone_number": "701-662-2157",
            "fax_number": "701-662-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALEDA",
        "first_name": "ROBERTO",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "7501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18843",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

Verify at the official NPI Registry.