NPIMap

Individual provider Active NPI

Nani Phillips Moss, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Skokie, IL
National Provider Identifier
1730574807
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
070669 Issued in CT
Practice address
9600 Gross Point Rd
Skokie, IL 60076-1214
Phone
(224) 251-2374
NPI assigned
Apr 5, 2015
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 63640 NY
Student in an Organized Health Care Education/Training Program 390200000X 036148810 IL
Obstetrics & Gynecology Physician 207V00000X 036.148810 IL
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 070669 CT Primary

Addresses

Primary practice location

9600 Gross Point Rd
Skokie, IL 60076-1214

Mailing address

47 New Scotland Ave
Department of OB/GYN
Albany, NY 12208-3412

Other practice location 1

47 New Scotland Ave
Dept of Ob/Gyn
Albany, NY 12208-3412
Phone (518) 264-5026

Other names 1

  • Nani Crashley Phillips Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220809002223 CT Practitioner - Obstetrics/Gynecology 9830435718 Reassigns benefits to 1 organization
I20220902001536 MA Practitioner - Obstetrics/Gynecology 9830435718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albany Medical College of Union University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

444 Montgomery St
Chicopee, MA 01020-1969
Phone (413) 594-3111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.148810ILMDObstetrics & Gynecology Physician
070669CTMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician
036148810ILMDStudent in an Organized Health Care Education/Training Program
63640NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Obstetrics & Gynecology CurrentSince Sep 1, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 1, 2022 Accepting new patients
Riverbend Medical Group, Inc CurrentSince Sep 1, 2022 Accepting new patients
Riverbend Medical Group, Inc. Obstetrics & Gynecology CurrentSince Sep 1, 2022 Accepting new patients
Saint Francis Care Medical Group, PC Past Accepting new patients
Mwa,PC Obstetrics & Gynecology Past Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

580 Cottage Grove Rd
Ste 205
Bloomfield, CT 06002
Phone (860) 286-2996

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: nmoss2390005@direct.trinity-health.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1730574807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "address_2": "DEPARTMENT OF OB/GYN",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 GROSS POINT RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761214",
            "telephone_number": "224-251-2374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Dept of Ob/Gyn",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-264-5026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSS",
        "first_name": "NANI",
        "middle_name": "PHILLIPS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-05",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "63640",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "036148810",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.148810",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CT",
            "license": "070669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANI",
            "last_name": "PHILLIPS",
            "middle_name": "CRASHLEY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.