Active NPI
Sandra A Moss, CRNP
- Adult Health Nurse Practitioner
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- SP007945
- Practice address
- 1015 Chestnut St Ste 1321
Philadelphia, PA 19107-4313 - Phone
- (215) 955-8435
- Fax
- (215) 955-2342
- NPI assigned
- Jun 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | VP005103D | PA | |
| Adult Health Nurse Practitioner | 363LA2200X | SP007945 | PA | Primary |
Addresses
Primary practice location
1015 Chestnut St Ste 1321
Philadelphia, PA 19107-4313
Mailing address
1015 Chestnut St Ste 1321
Philadelphia, PA 19107-4313
Phone (215) 955-9854
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232809585 | Other | PA | HEMATOLOGY |
| 23209585 | Medicaid | PA |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1015 Chestnut St
Suite 1321
Philadelphia, PA 19107-4313
Phone (215) 923-5676
Hospital & facility affiliations
- Thomas Jefferson University Hospital
- Jefferson Abington Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP007945 | PA | MD | Adult Health Nurse Practitioner |
| VP005103D | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson University Physicians | Current | Accepting new patients | |
| Jefferson University Physicians | Past | Accepting new patients |
Locations
1015 Chestnut St
Ste 1321
Philadelphia, PA 19107
Phone (215) 923-5676
1101 Chestnut St
#8
Philadelphia, PA 19107
Phone (215) 955-5869
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.
-
- General Practice Physician
- Philadelphia, PA
- NPI 1326093675
-
- Gastroenterology Physician
- Phila, PA
- NPI 1205898723
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Abington, PA
- NPI 1811992084
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496620800000",
"number": "1700315728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 CHESTNUT ST STE 1321",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074313",
"telephone_number": "215-955-9854",
"fax_number": "215-955-2342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 CHESTNUT ST STE 1321",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074313",
"telephone_number": "215-955-8435",
"fax_number": "215-955-2342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "SANDRA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-05",
"last_updated": "2017-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "VP005103D",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP007945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEMATOLOGY",
"identifier": "232809585",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "23209585",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.