Thomas Robert Moffett Jr., MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

R4045 Issued in AR

Practice address

11300 N Rodney Parham Rd
Suite 210
Little Rock, AR 72212-4153

Phone

(501) 663-4100

Fax

(501) 663-4145

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Arkansas Vascular Surgery, PLLC

  • Vascular Surgery Physician
  • Little Rock, AR
  • NPI 1235778515
  NPD

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1487655247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 N RODNEY PARHAM RD",
            "address_2": "SUITE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124153",
            "telephone_number": "501-663-4100",
            "fax_number": "501-663-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 N RODNEY PARHAM RD",
            "address_2": "SUITE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124153",
            "telephone_number": "501-663-4100",
            "fax_number": "501-663-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "R4045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117396001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "11923000000",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahagony Modest
• Pooja Modi
• Anne Moellers
• Angie Moench, RT
• Kelly Moffett Place, LPC
• Solomon C Mogbo, M.D
• Kevin Todd Mogish, MHPP
• Ayman Zakaria Ahmed Mohamed, MD
• Mazar Mohamed Yousif Mohamed, MD
• Amr Mohammed, MD

• Plastic Surgery Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Plastic Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.