Individual provider Active NPI

Elliotte Moss, M.D.

  • Internal Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1548245632
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301029998 Issued in MI
Practice address
30840 Telegraph Road
Suite 300
Farmington Hills, MI 48334-2555
Phone
(248) 932-8725
Fax
(248) 932-8977
NPI assigned
Dec 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301029998 MI Primary

Addresses

Primary practice location

30840 Telegraph Road
Suite 300
Farmington Hills, MI 48334-2555

Mailing address

30840 Telegraph Road
Suite 300
Farmington Hills, MI 48334-2555
Phone (248) 932-8725

Other identifiers 2

IdentifierTypeStateIssuer
700F319250OtherMIBLUE SHIELD
1548245632MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090805000454 MI Practitioner - Internal MedicinePractitioner - Gastroenterology 2567515729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Wayne State University School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
Michigan Healthcare Professionals PC Internal Medicine Current Accepting new patients
Jawad a Shah MD PC CurrentSince Mar 17, 2020 Accepting new patients
Jawad a Shah, MD PC CurrentSince Mar 17, 2020 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

32255 Northwestern Hwy
Ste 170
Farmington Hills, MI 48334
Phone (248) 932-1250

30840 Northwestern Hwy
Ste 300
Farmington Hills, MI 48334
Phone (248) 932-1250

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

28625 Northwestern Hwy
Ste 213
Southfield, MI 48034
Phone (248) 354-9666

21230 Dequindre Rd
Warren, MI 48091
Phone (586) 427-1000

Interoperability endpoints

  • Direct secure messaging: elliottemoss@internalmedicinephysicians.directglo.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 3

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": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1548245632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30840 TELEGRAPH ROAD",
            "address_2": "SUITE 300",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342555",
            "telephone_number": "248-932-8725",
            "fax_number": "248-932-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30840 TELEGRAPH ROAD",
            "address_2": "SUITE 300",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342555",
            "telephone_number": "248-932-8725",
            "fax_number": "248-932-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "ELLIOTTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-12",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301029998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "700F319250",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548245632",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.