Michael J Moulton, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

34904 Issued in AZ

Practice address

988102 Nebraska Medical Center
Omaha, NE 68198-8102

Phone

(402) 559-9800

Fax

(402) 559-7929

NPI assigned

Aug 13, 2006

Last updated

Oct 9, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE, IA2 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 2

Specialty

Thoracic SurgeryAlso: General Surgery

Education

Harvard Medical School, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
• Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmoulton25664@direct.nebraskamed.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114

  IA

  Medicare reassignment Care Compare group NPD
• The Nebraska Medical Center

  dba The Nebraska Medical Center - Nebraska Medicine

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  NPD (past)

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

• Bellevue Medical Center LLC

  dba Bellevue Medical Center - Nebraska Medicine

  • General Acute Care Hospital
  • Bellevue, NE
  • NPI 1609007525
  Care Compare affiliation
• The Nebraska Medical Center

  dba The Nebraska Medical Center - Nebraska Medicine

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1710999024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-9800",
            "fax_number": "402-559-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-9800",
            "fax_number": "402-559-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AZ",
            "license": "34904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124508",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026059800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00439640",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Michael Motwani, D.O
• Tereza Mou
• Mohamed Moudachirou
• Balkissou Mouhamed
• Rabia Moukrad, APRN
• Rexford Moulton
• Richard Lee Moulton
• Kraig Moultrie, P.T.A.
• Brianna Mount, OTD, OTR/L
• Tymara N Mountain-Devers

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.

Verify at the official NPI Registry.