Individual provider Active NPI

Robert Moy, MD

  • Pediatric Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1467030866
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
MT231446 Issued in PA
Practice address
3401 Civic Center Blvd
Division of Pediatric Nephrology
Philadelphia, PA 19104
Phone
(215) 590-2449
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X MT231446 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Division of Pediatric Nephrology
Philadelphia, PA 19104

Mailing address

1524 Scott Ave Unit 434
Charlotte, NC 28203-1518
Phone (443) 257-5830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210730001149 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0840693677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT231446PAMDPediatric Nephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1467030866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 SCOTT AVE UNIT 434",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282031518",
            "telephone_number": "443-257-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC NEPHROLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "PA",
            "license": "MT231446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.