Individual provider Active NPI

Daniel Adley Moss, PH.D.

  • Psychologist
  • Englewood, NJ
National Provider Identifier
1437217254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3327 Issued in NJ
Practice address
21 W Hudson Ave
Englewood, NJ 07631-1744
Phone
(201) 567-1516
Fax
(201) 871-4667
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3327 NJ Primary

Addresses

Primary practice location

21 W Hudson Ave
Englewood, NJ 07631-1744

Mailing address

21 W Hudson Ave
Englewood, NJ 07631-1744
Phone (201) 567-1516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050602000436 NJ Practitioner - Clinical Psychologist 3678516531 Practice locations: Englewood, NJ
I20111228000055 NY Practitioner - Clinical Psychologist 3678516531 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

163 Engle St
BLDG. 2
Englewood, NJ 07631-2519
Phone (201) 567-1516

163 Engle St
BLDG. 2
Englewood, NJ 07631-2530

21 W Hudson Ave
Englewood, NJ 07631-1744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3327NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437217254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W HUDSON AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311744",
            "telephone_number": "201-567-1516",
            "fax_number": "201-871-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W HUDSON AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311744",
            "telephone_number": "201-567-1516",
            "fax_number": "201-871-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DANIEL",
        "middle_name": "ADLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "3327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.