Active NPI
Lisa B. Moreno, M.D.
- Pediatric Allergy/Immunology Physician
- New York, NY
National Provider Identifier
1508977208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Allergy/Immunology Physician
- License
- 223927
- Practice address
- 135 E 83Rd St
New York, NY 10028-2408 - Phone
- (212) 686-6321
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD044781 | DC | |
| Allergy & Immunology Physician | 207K00000X | 223927 | NY | |
| Pediatrics Physician | 208000000X | 223927 | NY | |
| Pediatric Allergy/Immunology Physician | 2080P0201X | 223927 | NY | Primary |
Addresses
Primary practice location
135 E 83Rd St
New York, NY 10028-2408
Mailing address
12 E 86TH St Apt 1530
New York, NY 10028-0516
Phone (718) 350-6680
Other practice location 1
110 W 97th St
New York, NY 10025-6450
Phone (212) 749-1820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD044781 | DC | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William F Ryan Community Health Center Inc | Current | Accepting new patients | |
| William F Ryan Community Health Center Inc | Current | Accepting new patients | |
| Allergy & Asthma Associates of Murray Hill, P C | Allergy & Immunology | Past | Accepting new patients |
| Ear, Nose & Throat Associates of New York,P.C. | Past | Accepting new patients | |
| Midtown Sinus Imaging, PLLC | Past | Accepting new patients | |
| ENT and Allergy Associates LLP | Allergy & Immunology | Past | Accepting new patients |
Locations
110 W 97th St
New York, NY 10025
Phone (212) 316-7906
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 7
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.
-
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1851328199
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
dba Ryan Health Midtown Emotional Wellness Center
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1043079064
-
- Allergy & Immunology Physician
- New York, NY
- NPI 1245421171
-
- Facial Plastic Surgery Physician
- Fresh Meadows, NY
- NPI 1124079769
-
- Otolaryngology Physician
- Tarrytown, NY
- NPI 1376598326
Allergy & Immunology
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1801070412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1508977208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 E 86TH ST APT 1530",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100280516",
"telephone_number": "718-350-6680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 E 83RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100282408",
"telephone_number": "212-686-6321"
}
],
"practiceLocations": [
{
"address_1": "110 W 97th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100256450",
"country_code": "US",
"telephone_number": "212-749-1820",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORENO",
"first_name": "LISA",
"middle_name": "B.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "DC",
"license": "MD044781",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NY",
"license": "223927",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "223927",
"primary": false
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "NY",
"license": "223927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.