NPIMap

Organization Active NPI

Moideen M Moopen MD PA

  • Gastroenterology Physician
  • Port Charlotte, FL
National Provider Identifier
1497892384
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME35706 Issued in FL
Legal business name
MOIDEEN M MOOPEN MD PA
Practice address
2400 Harbor Blvd
Suite #19
Port Charlotte, FL 33952-5038
Phone
(941) 625-1391
Fax
(941) 624-0635
NPI assigned
Jan 31, 2007
Last updated
Sep 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Mr. Moideen M Moopen, MDNPI 1205944758
Title
Physician
Phone
(941) 625-1391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME35706 FL
Gastroenterology Physician 207RG0100X ME35706 FL Primary

Addresses

Primary practice location

2400 Harbor Blvd
Suite #19
Port Charlotte, FL 33952-5038

Mailing address

2400 Harbor Blvd
Suite #19
Port Charlotte, FL 33952-5038
Phone (941) 625-1391

Other identifiers 1

IdentifierTypeStateIssuer
08095OtherFLBCBS OF FLORIDA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1497892384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD",
            "address_2": "SUITE #19",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525038",
            "telephone_number": "941-625-1391",
            "fax_number": "941-624-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD",
            "address_2": "SUITE #19",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525038",
            "telephone_number": "941-625-1391",
            "fax_number": "941-624-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOIDEEN M MOOPEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "MOOPEN",
        "authorized_official_first_name": "MOIDEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "941-625-1391",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME35706",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME35706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "08095",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.