Individual provider Active NPI

Amy M Moschell, MD

  • Ophthalmology Physician
  • Greenfield, WI
National Provider Identifier
1679575823
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
45221 Issued in WI
Practice address
3033 W Layton Ave Ste 101
Greenfield, WI 53221-2628
Phone
(414) 279-5579
Fax
(414) 249-3299
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 45221 WI Primary

Addresses

Primary practice location

3033 W Layton Ave Ste 101
Greenfield, WI 53221-2628

Mailing address

3033 W Layton Ave Ste 101
Greenfield, WI 53221-2628
Phone (414) 279-5579

Other practice location 1

2424 S 90th St
Ste 506
West Allis, WI 53227-2455
Phone (414) 328-8760

Other identifiers 2

IdentifierTypeStateIssuer
34368000MedicaidWI
P00002002OtherWIPALMETTO GBA-RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050825000586 WI Practitioner - Ophthalmology 1951332360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard D Davenport MD and Associates SCGroup PAC ID 6103857503, 2 clinicians

Practice addresses (Care Compare)

2424 S 90TH St
Suite 506
West Allis, WI 53227-2455
Phone (414) 328-8760

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Richard D Davenport MD and Associates, SC Ophthalmology CurrentSince Sep 1, 2005 Accepting new patients

Locations

3033 W Layton Ave
Ste 101
Greenfield, WI 53221
Phone (414) 279-5579

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

2356 S 102nd St
West Allis, WI 53227
Phone (414) 336-3000

2424 S 90th St
Ste 506
West Allis, WI 53227
Phone (414) 328-6000

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1679575823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE STE 101",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-279-5579",
            "fax_number": "414-249-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE STE 101",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-279-5579",
            "fax_number": "414-249-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 S 90th St",
            "address_2": "Ste 506",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532272455",
            "country_code": "US",
            "telephone_number": "414-328-8760",
            "fax_number": "414-328-8763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSCHELL",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "45221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34368000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD",
            "identifier": "P00002002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.