Individual provider Active NPI

Robert David Moses, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chestnut Hill, MA
National Provider Identifier
1477692853
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
81406 Issued in MA
Practice address
334 Clyde St # 3
Chestnut Hill, MA 02467-2910
Phone
(617) 232-6830
Fax
(617) 232-6830
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 81406 MA Primary

Addresses

Primary practice location

334 Clyde St # 3
Chestnut Hill, MA 02467-2910

Mailing address

334 Clyde St #3
Chestnut Hill, MA 02467-2910
Phone (617) 232-6830

Other identifiers 1

IdentifierTypeStateIssuer
3147916MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040218000064 MA Practitioner - Thoracic Surgery 1658266739 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81406MAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New England Baptist Medical Associates, Inc. CurrentSince Apr 19, 2009 Accepting new patients

Locations

125 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 264-1100

Interoperability endpoints

  • Direct secure messaging: robert.moses@2653.securemail.prognocis.com
  • Direct secure messaging: rmoses254279@direct.bilh.masshiway.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1477692853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 CLYDE ST #3",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672910",
            "telephone_number": "617-232-6830",
            "fax_number": "617-934-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 CLYDE ST # 3",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672910",
            "telephone_number": "617-232-6830",
            "fax_number": "617-232-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "81406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3147916",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.