Individual provider Active NPI

Richard H. Moseley, M.D.

  • Gastroenterology Physician
  • Boulder, CO
National Provider Identifier
1447343843
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DR.0053480 Issued in CO
Practice address
1755 48TH St Ste 100
Boulder, CO 80301-2712
Phone
(303) 604-5000
Fax
(720) 890-0364
NPI assigned
Sep 30, 2006
Last updated
Mar 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301049366 MI
Gastroenterology Physician 207RG0100X 4301049366 MI
Gastroenterology Physician 207RG0100X DR.0053480 CO Primary

Addresses

Primary practice location

1755 48TH St Ste 100
Boulder, CO 80301-2712

Mailing address

382 S Arthur Ave
Louisville, CO 80027-3094
Phone (303) 604-5000

Other identifiers 3

IdentifierTypeStateIssuer
1679966MedicaidMI
4384140MedicaidMI
72027746MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140325001886 CO Practitioner - Gastroenterology 6305975962 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0053480COMDGastroenterology Physician
4301049366MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Gastroenterology Inc. Gastroenterology CurrentSince Mar 5, 2014 Accepting new patients
Boulder Valley Gastroenterology Inc. Gastroenterology Current Accepting new patients
Northglenn Endoscopy Center LLC Past Accepting new patients

Locations

1755 48th St
Ste 100
Boulder, CO 80301
Phone (720) 932-7714

1000 W South Boulder Rd
Ste 200
Lafayette, CO 80026
Phone (303) 604-4664

382 S Arthur Ave
Louisville, CO 80027

382 S Arthur Ave
Unit 100
Louisville, CO 80027

382 S Arthur Ave
Unit 140
Louisville, CO 80027

Interoperability endpoints

  • Direct secure messaging: r.moseley@gastrorockies.directbygreenway.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1447343843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S ARTHUR AVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800273094",
            "telephone_number": "303-604-5000",
            "fax_number": "720-890-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 48TH ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012712",
            "telephone_number": "303-604-5000",
            "fax_number": "720-890-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "RICHARD",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301049366",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301049366",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "DR.0053480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679966",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4384140",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72027746",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.