NPIMap

Individual provider Active NPI

Robert Leslie Moss, MD

  • Internal Medicine Physician
  • Reisterstown, MD
National Provider Identifier
1659304871
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D32882 Issued in MD
Practice address
114 Business Center Drive
Reisterstown, MD 21136
Phone
(410) 833-2772
Fax
(410) 526-4897
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X D0032882 MD
Internal Medicine Physician 207R00000X D0032882 MD
Internal Medicine Physician 207R00000X D32882 MD Primary

Addresses

Primary practice location

114 Business Center Drive
Reisterstown, MD 21136

Mailing address

114 Business Center Drive
Reisterstown, MD 21136
Phone (410) 833-2772

Other identifiers 4

IdentifierTypeStateIssuer
75792OtherMDAETNA
405231500MedicaidMD
KF68 / 351268-01OtherMDBC/BS OF MD
S190 / 0017OtherMDBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100422000709 MD Practitioner - Internal Medicine 9830226893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

114 Business Ctr Dr
Reisterstown, MD 21136-1229
Phone (410) 833-2772

2525 Pot Spring Rd
Timonium, MD 21093-2778
Phone (800) 657-6268

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0032882MDMDInternal Medicine Physician
D32882MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Family Care, Inc. Internal Medicine CurrentSince Mar 1, 2000 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Integrace Health Inc Geriatric Medicine Past Accepting new patients

Locations

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

114 Business Center Dr
Reisterstown, MD 21136
Phone (410) 661-3338

Interoperability endpoints

  • Direct secure messaging: mmoss6614@direct.mdmercy.com

Organizations & group practices 3

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 10

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1659304871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BUSINESS CENTER DRIVE",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "21136",
            "telephone_number": "410-833-2772",
            "fax_number": "410-526-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BUSINESS CENTER DRIVE",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "21136",
            "telephone_number": "410-833-2772",
            "fax_number": "410-526-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "ROBERT",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0032882",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0032882",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D32882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "75792",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405231500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MD",
            "identifier": "KF68 / 351268-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "S190 / 0017",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

Verify at the official NPI Registry.