Individual provider Active NPI

Barbara D'Agnoluzzo Moreira, M.D.

  • Vascular Surgery Physician
  • Detroit, MI
National Provider Identifier
1437383197
Registry record updated May 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301091483 Issued in MI
Practice address
3663 Woodward Ave Ste 200
Wsu Detroit Medical Center
Detroit, MI 48201-2400
Phone
(313) 745-8875
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301091483 MI Primary

Addresses

Primary practice location

3663 Woodward Ave Ste 200
Wsu Detroit Medical Center
Detroit, MI 48201-2400

Mailing address

80 E Hancock St Apt 408
Detroit, MI 48201-1328
Phone (313) 529-4695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301091483MIMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1437383197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 E HANCOCK ST APT 408",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011328",
            "telephone_number": "313-529-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 WOODWARD AVE STE 200",
            "address_2": "WSU DETROIT MEDICAL CENTER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012400",
            "telephone_number": "313-745-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREIRA",
        "first_name": "BARBARA",
        "middle_name": "D'AGNOLUZZO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301091483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.