Individual provider Active NPI

Robert Frank Moya-Mendez, M.D.

  • Internal Medicine Physician
  • Boonton, NJ
National Provider Identifier
1659394153
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA40227 Issued in NJ
Practice address
204 Church St
Boonton, NJ 07005-1454
Phone
(973) 334-0736
Fax
(973) 334-2855
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA40227 NJ Primary

Addresses

Primary practice location

204 Church St
Boonton, NJ 07005-1454

Mailing address

204 Church St
Boonton, NJ 07005-1454
Phone (973) 334-0736

Other identifiers 1

IdentifierTypeStateIssuer
3379302MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100607000737 NJ Practitioner - Internal Medicine 2062542798 Practice locations: Boonton, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA40227NJMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659394153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CHURCH ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051454",
            "telephone_number": "973-334-0736",
            "fax_number": "973-334-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CHURCH ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051454",
            "telephone_number": "973-334-0736",
            "fax_number": "973-334-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA-MENDEZ",
        "first_name": "ROBERT",
        "middle_name": "FRANK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA40227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3379302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonton, NJ

Sources for this page

Verify at the official NPI Registry.