Individual provider Active NPI

Medgar Marcial Moya, MD

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1619974706
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41671 Issued in AZ
Practice address
1323 W Prince Rd
Tucson, AZ 85705-3114
Phone
(520) 887-0800
Fax
(520) 887-1393
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41671 AZ Primary

Addresses

Primary practice location

1323 W Prince Rd
Tucson, AZ 85705-3114

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Other identifiers 1

IdentifierTypeStateIssuer
419727MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41671AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marana Health Center, Inc Past Accepting new patients

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1619974706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-682-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 W PRINCE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053114",
            "telephone_number": "520-887-0800",
            "fax_number": "520-887-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "MEDGAR",
        "middle_name": "MARCIAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "41671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419727",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.