Individual provider Active NPI

Henry Lee Moss III

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1699238329
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD489417 Issued in PA
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1100
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MD489417 PA Primary

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1100

Other practice location 1

177 Fort Washington Ave
New York, NY 10032-3733
Phone (212) 305-3038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250505000443 PA Practitioner - Diagnostic Radiology 4183952674 Reassigns benefits to 11 organizations
I20251204003472 CA Practitioner - Diagnostic Radiology 4183952674 Reassigns benefits to 1 organization
I20251222001391 TX Practitioner - Diagnostic Radiology 4183952674 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Englewood Radiologic Group P aGroup PAC ID 6901852300, 131 clinicians
Virtual Radiologic Professionals LLCGroup PAC ID 4981608817, 392 clinicians
Warren General HospitalGroup PAC ID 4880501402, 100 clinicians

Practice addresses (Care Compare)

1147 N 4TH St
Unit 2Ab
Philadelphia, PA 19123-1571
Phone (570) 271-6144

166 Gallagherville Rd
Downingtown, PA 19335-2248
Phone (952) 595-1100

901 N Penn St
P302 Warren Radiology Group Philadelph
Philadelphia, PA 19123-3132
Phone (814) 723-4973

Hospital & facility affiliations

  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Highland Hospital Hospital, Oakland, CA, CCN 050320
  • The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ton San Xavier Health Center CurrentSince Oct 23, 2025 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 23, 2025 Accepting new patients
Kern County Hospital Authority CurrentSince Jun 8, 2025 Accepting new patients
Claremont Imaging Associates, a Medical Corporation Diagnostic Radiology CurrentSince Apr 15, 2025 Accepting new patients
Geisinger Clinic CurrentSince Jul 28, 2025 Accepting new patients
Ton San Simon Health Center CurrentSince Oct 23, 2025 Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince May 1, 2025 Accepting new patients
Geisinger Clinic Current Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Sep 21, 2025 Accepting new patients
Warren General Hospital Current Accepting new patients
Warren General Hospital Diagnostic Radiology CurrentSince Jul 7, 2025 Accepting new patients
Crouse Radiology Associates LLP Diagnostic Radiology CurrentSince Nov 11, 2025 Accepting new patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince Sep 12, 2025 Accepting new patients
The Unity Hospital of Rochester CurrentSince Nov 11, 2025 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 23, 2025 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Jul 28, 2025 Accepting new patients
Rochester General Hospital CurrentSince Nov 11, 2025 Accepting new patients
United Memorial Medical Center CurrentSince Nov 11, 2025 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Sep 21, 2025 Accepting new patients
Warren General Hospital CurrentSince Jul 7, 2025 Accepting new patients
Ton Sells Hospital CurrentSince Oct 23, 2025 Accepting new patients
Rochester General Hospital CurrentSince Nov 11, 2025 Accepting new patients
Virtual Radiologic Professionals of Texas I, P.a. Diagnostic Radiology Past Accepting new patients
Ton Sells Hospital Past Accepting new patients
Alameda Health System Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients

Locations

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

300 Canal St
King City, CA 93930
Phone (831) 385-6000

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

2 W Crescent Park
#P
Warren, PA 16365
Phone (814) 723-3300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDEGCD

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1699238329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323733",
            "country_code": "US",
            "telephone_number": "212-305-3038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSS",
        "first_name": "HENRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD489417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.