Individual provider Active NPI

Roger Grant Moblad, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Kerrville, TX
National Provider Identifier
1467553875
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0468 Issued in TX
Practice address
224 Wesley Dr
Kerrville, TX 78028-5809
Phone
(830) 257-7677
Fax
(830) 257-7666
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0468 TX Primary

Addresses

Primary practice location

224 Wesley Dr
Kerrville, TX 78028-5809

Mailing address

224 Wesley Dr
Kerrville, TX 78028-5809
Phone (830) 257-7677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091229000690 TX Practitioner - Podiatry 1052451820 Practice locations: Kerrville, TX

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

224 Wesley Dr
Kerrville, TX 78028-5809

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue178
Removal of skin lesions1-10
Removal of nail tissue126
Removal or shaving of skin growth42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0468TXMDFoot & Ankle Surgery Podiatrist
468TXMDOrthotist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1467553875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 WESLEY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285809",
            "telephone_number": "830-257-7677",
            "fax_number": "830-257-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 WESLEY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285809",
            "telephone_number": "830-257-7677",
            "fax_number": "830-257-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLAD",
        "first_name": "ROGER",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "0468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

Verify at the official NPI Registry.