Individual provider Active NPI

Shoshana Moss

  • Family Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1467269019
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15222500 Issued in NJ
Practice address
685 River Ave
Lakewood, NJ 08701-5288
Phone
(732) 486-7373
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ15222500 NJ Primary

Addresses

Primary practice location

685 River Ave
Lakewood, NJ 08701-5288

Mailing address

232 Brook Ave
Passaic, NJ 07055-3340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113003762 NJ Practitioner - Nurse Practitioner 3375071772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal NP Services LLCGroup PAC ID 9335455179, 65 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 102
Lakewood, NJ 08701-6124
Phone (732) 486-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15222500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal NP Services, LLC CurrentSince Jan 1, 2025 Accepting new patients
Vitality NP Group LLC PastSince Jan 1, 2025 Accepting new patients

Locations

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

Organizations & group practices 2

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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1467269019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 BROOK AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015288",
            "telephone_number": "732-486-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "SHOSHANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15222500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.