Individual provider Active NPI

Ata S Moshiri, MD, MPH

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1619394780
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
320246 Issued in NY
Practice address
222 E 41St St FL 25
New York, NY 10017-6739
Phone
(212) 263-7250
Fax
(212) 263-1683
NPI assigned
Mar 26, 2014
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD60949822 WA
Dermatology Physician 207N00000X 320246 NY Primary
Dermatopathology Physician 207ND0900X 320246 NY
Dermatopathology Physician 207ND0900X MD60949822 WA

Addresses

Primary practice location

222 E 41St St FL 25
New York, NY 10017-6739

Mailing address

222 E 41St St FL 25
New York, NY 10017-6739
Phone (212) 263-7250

Other practice location 1

825 Eastlake Ave E
Seattle, WA 98109-4405
Phone (855) 557-0555

Other practice location 2

4225 Roosevelt Way NE Fl 4
Seattle, WA 98105-6099
Phone (206) 598-2267

Other identifiers 1

IdentifierTypeStateIssuer
1619394780MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amoshiri543928@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230119002445 NY Practitioner - Dermatology 8325363435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Washington School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320246NYMDDermatology Physician
MD60949822WAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 1, 2023 Accepting new patients
New York University CurrentSince Feb 1, 2023 Accepting new patients

Networks

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

Organizations & group practices 2

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 7

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1619394780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739",
            "telephone_number": "212-263-7250",
            "fax_number": "212-263-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739",
            "telephone_number": "212-263-7250",
            "fax_number": "212-263-1683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Eastlake Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981094405",
            "country_code": "US",
            "telephone_number": "855-557-0555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4225 Roosevelt Way NE Fl 4",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056099",
            "country_code": "US",
            "telephone_number": "206-598-2267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSHIRI",
        "first_name": "ATA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60949822",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "320246",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": "320246",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "MD60949822",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619394780",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amoshiri543928@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 E 41st St Fl 25",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100176739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.