Individual provider Active NPI

Marisa Christina Moreta, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1659729481
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OS020779 Issued in PA
Practice address
25 S 9TH St FL 1
Philadelphia, PA 19107-4408
Phone
(215) 955-1200
Fax
(215) 923-6808
NPI assigned
Jun 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X OS020779 PA Primary

Addresses

Primary practice location

25 S 9TH St FL 1
Philadelphia, PA 19107-4408

Mailing address

25 S 9TH St FL 1
Philadelphia, PA 19107-4408
Phone (215) 955-1200

Other practice location 1

3 Crescent Dr Fl 3
Philadelphia, PA 19112-1016
Phone (215) 503-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201008001121 PA Practitioner - Physical Medicine and Rehabilitation 6608164892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

25 S 9TH St
1St Floor
Philadelphia, PA 19107-4408
Phone (215) 955-1200

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Physical Medicine & Rehabilitation CurrentSince Oct 1, 2020 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

3 Crescent Dr
Fl 3
Philadelphia, PA 19112
Phone (215) 503-3321

3 Crescent Dr
Ste 100
Philadelphia, PA 19112
Phone (215) 503-3300

25 S 9th St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1200

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1659729481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S 9TH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074408",
            "telephone_number": "215-955-1200",
            "fax_number": "215-923-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S 9TH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074408",
            "telephone_number": "215-955-1200",
            "fax_number": "215-923-6808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Crescent Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191121016",
            "country_code": "US",
            "telephone_number": "215-503-3321",
            "fax_number": "215-503-7180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORETA",
        "first_name": "MARISA",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OS020779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.