Individual provider Active NPI

Joan Michelle Moccia, ANP

  • Adult Health Nurse Practitioner
  • Northville, MI
National Provider Identifier
1528365889
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704108717 Issued in MI
Practice address
21800 Haggerty Rd Ste 113
Northville, MI 48167-9051
Phone
(248) 277-3110
NPI assigned
Feb 23, 2011
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704108717 MI Primary

Addresses

Primary practice location

21800 Haggerty Rd Ste 113
Northville, MI 48167-9051

Mailing address

21800 Haggerty Rd Ste 113
Northville, MI 48167-9051
Phone (248) 277-3110

Other practice location 1

36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110627000525 MI Practitioner - Nurse Practitioner 1254519069 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704108717MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Hospital Crna Current Accepting new patients
St Mary Mercy Physician Practices CurrentSince Jan 1, 2017 Accepting new patients
Avalon Consultants PLLC CurrentSince Apr 19, 2023 Accepting new patients
St Mary Mercy Physician Practices CurrentSince Jan 1, 2017 Accepting new patients
St Mary Mercy Hospital Current Accepting new patients

Locations

14555 Levan Rd
Ste 112
Livonia, MI 48154
Phone (734) 712-1000

19000 St Joes Pkwy
Ste 310
Livonia, MI 48152
Phone (248) 743-4490

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

21800 Haggerty Rd
Ste 113
Northville, MI 48167
Phone (734) 369-2100

Interoperability endpoints

  • Direct secure messaging: jmoccia24642@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1528365889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21800 HAGGERTY RD STE 113",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481679051",
            "telephone_number": "248-277-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 HAGGERTY RD STE 113",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481679051",
            "telephone_number": "248-277-3110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36475 Five Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481541971",
            "country_code": "US",
            "telephone_number": "734-655-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCCIA",
        "first_name": "JOAN",
        "middle_name": "MICHELLE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704108717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

Verify at the official NPI Registry.