Individual provider Active NPI

Diana B Moise, MD

  • Hospitalist Physician
  • Hartford, CT
National Provider Identifier
1508166596
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
053730 Issued in CT
Practice address
114 Woodland St
Hartford, CT 06105-1208
Phone
(860) 714-7446
Fax
(860) 714-1508
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X BP20050261 TX
Hospitalist Physician 208M00000X 053730 CT Primary

Addresses

Primary practice location

114 Woodland St
Hartford, CT 06105-1208

Mailing address

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-7446

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmoise561326@direct.sw.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007001862 TX Practitioner - Internal Medicine 9537453048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 926-2544

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP20050261TXMDNephrology Physician
053730CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 1, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 1, 2019 Accepting new patients
Healthtexas Provider Network Hospitalist Current Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Baylor All Saints Medical Center Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1508166596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-7446",
            "fax_number": "860-714-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-7446",
            "fax_number": "860-714-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISE",
        "first_name": "DIANA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "BP20050261",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "053730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoise561326@direct.sw.org",
            "affiliation": "N",
            "address_1": "1400 8th Ave Ste C770",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.