Active NPI
David A Mosborg, MD
- Otolaryngology Physician
- Orange Park, FL
National Provider Identifier
1649236332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME0061356
- Practice address
- 1895 Kingsley Ave
Suite 703
Orange Park, FL 32073 - Phone
- (904) 276-1446
- Fax
- (904) 276-1448
- NPI assigned
- Apr 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | ME0061356 | FL | Primary |
Addresses
Primary practice location
1895 Kingsley Ave
Suite 703
Orange Park, FL 32073
Mailing address
1895 Kingsley Ave
Suite 703
Orange Park, FL 32073
Phone (904) 276-1446
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14755 | Other | FL | BCBS OF FL |
| 219186 | Other | FL | AVMED |
| 2145892002 | Other | FL | CIGNA |
| 4275862 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101028000153 | FL | Practitioner - Otolaryngology | 7911009493 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0061356 | FL | MD | Otolaryngology Physician |
Interoperability endpoints
- david.mosborg.1@8967.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1649236332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1895 KINGSLEY AVE",
"address_2": "SUITE 703",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "32073",
"telephone_number": "904-276-1446",
"fax_number": "904-276-1448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1895 KINGSLEY AVE",
"address_2": "SUITE 703",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "32073",
"telephone_number": "904-276-1446",
"fax_number": "904-276-1448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSBORG",
"first_name": "DAVID",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-22",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME0061356",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF FL",
"identifier": "14755",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "219186",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2145892002",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4275862",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.