Individual provider Active NPI

Moya C Rose, MPT

  • Physical Therapist
  • Springfield, MA
National Provider Identifier
1689655227
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17425 Issued in MA
Practice address
101 Wason Ave FL 3
Springfield, MA 01107-1140
Phone
(413) 887-5130
Fax
(413) 733-1924
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17425 MA Primary

Addresses

Primary practice location

101 Wason Ave FL 3
Springfield, MA 01107-1140

Mailing address

101 Wason Ave FL 3
Springfield, MA 01107-1140
Phone (413) 887-5130

Other names 1

  • Moya CR Reuter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17425MAMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: moya.rose@ccalliance.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1689655227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WASON AVE FL 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071140",
            "telephone_number": "413-887-5130",
            "fax_number": "413-733-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WASON AVE FL 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071140",
            "telephone_number": "413-887-5130",
            "fax_number": "413-733-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MOYA",
        "middle_name": "C",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOYA",
            "last_name": "REUTER",
            "middle_name": "CR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.