Individual provider Active NPI

Cotie Elaine Moss, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1548056039
Registry record updated Aug 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R250522 Issued in MD
Practice address
4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone
(443) 675-1360
NPI assigned
Apr 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R250522 MD
Family Nurse Practitioner 363LF0000X R250522 MD Primary

Addresses

Primary practice location

4340 Park Heights Ave
Baltimore, MD 21215-6725

Mailing address

4340 Park Heights Ave
Baltimore, MD 21215-6725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20251016003247 MD Practitioner - Nurse Practitioner 2264929876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Heights Medical Clinic LLCGroup PAC ID 7012012651, 7 clinicians

Practice addresses (Care Compare)

4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone (410) 542-8130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Heights Medical Clinic LLC CurrentSince Aug 27, 2025 Accepting new patients

Locations

4340 Park Heights Ave
Baltimore, MD 21215
Phone (410) 542-8130

301 International Cir
Hunt Valley, MD 21030
Phone (410) 433-2200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1745020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755388800000",
    "number": "1548056039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "443-675-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "COTIE",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-19",
        "last_updated": "2025-08-17",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R250522",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R250522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.