Roberto Antonio Moran, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

313493 Issued in NY

Practice address

10211 Roosevelt Ave Ste 4
Corona, NY 11368-2331

Phone

(718) 898-1386

Fax

(718) 898-1093

NPI assigned

Jun 4, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

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.

• Sop Medical PC

  • Primary Care Clinic/Center
  • Corona, NY
  • NPI 1083805741
  Medicare reassignment NPD
• Greenpoint Medical PC

  • Primary Care Clinic/Center
  • Sunnyside, NY
  • NPI 1942509765
  NPD (past)
• Jose a Baez MD PC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1982978326
  NPD (past)
• Maria C. Coe, MSRD,CDN,PC

  • Health Service Clinic/Center
  • Corona, NY
  • NPI 1417361122
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1528550647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 ROOSEVELT AVE STE 4",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331",
            "telephone_number": "718-898-1386",
            "fax_number": "718-898-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 ROOSEVELT AVE STE 4",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331",
            "telephone_number": "718-898-1386",
            "fax_number": "718-898-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "ROBERTO",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125072763",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "313493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06873725",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Alicia Montero
• Luis M Montero
• Jose Montoya
• Moon Rehab PT PC
• Solmaira Morales
• Bilma J Morocho
• Igor Mosheyev
• Henry Moskowitz, MD
• Mercedes Mota-Martinez, DDS
• Motion Forward Physical Therapy PC

• Family Medicine Physician in Corona, NY
• Providers in Corona, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.

Verify at the official NPI Registry.