NPIMap

Individual provider Active NPI

Moises Siperstein-Blumovicz, M.D.

  • Internal Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1568436103
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME-76469 Issued in FL
Practice address
10377 S US Highway 1
Suite 102
Port Saint Lucie, FL 34952-5630
Phone
(772) 337-7811
Fax
(772) 337-7833
NPI assigned
Feb 13, 2006
Last updated
Mar 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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 ME-76469 FL Primary

Addresses

Primary practice location

10377 S US Highway 1
Suite 102
Port Saint Lucie, FL 34952-5630

Mailing address

10377 S US Highway 1
Suite 102
Port Saint Lucie, FL 34952-5630
Phone (772) 337-7811

Other identifiers 1

IdentifierTypeStateIssuer
04845160OtherECFMG NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000187 FL Practitioner - Internal Medicine 1254400450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10377S US Hwy 1 102
Port Saint Lucie, FL 34952-5630
Phone (772) 337-7811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.54 of 100Reported as individual
Quality
87.09
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME-76469FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moises Siperstein MD PA Internal Medicine CurrentSince Feb 25, 2008 Accepting new patients

Locations

10377 S US Highway 1
Ste 102
Port St Lucie, FL 34952
Phone (772) 337-7811

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCAHCA/Endpoint/CCAHCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CCAHCA

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

Hospital & facility affiliations 8

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1568436103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10377 S US HIGHWAY 1",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525630",
            "telephone_number": "772-337-7811",
            "fax_number": "772-337-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10377 S US HIGHWAY 1",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525630",
            "telephone_number": "772-337-7811",
            "fax_number": "772-337-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPERSTEIN-BLUMOVICZ",
        "first_name": "MOISES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME-76469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG NUMBER",
            "identifier": "04845160",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.