Roger M Moczygemba, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J2212 Issued in TX

Practice address

1010 NW Loop 410 Ste 100a
San Antonio, TX 78213-2220

Phone

(210) 886-8031

Fax

(210) 886-8059

NPI assigned

Aug 2, 2005

Last updated

Mar 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Direct Medical PLLC

  dba Direct Med Clinic

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1689104846
  Authorized official Same address or phone
• Alivio Health and Wellness LLC

  • Medical Physician Assistant
  • San Antonio, TX
  • NPI 1982193462
  NPD (past)
• Pain & Neuromuscular Clinic of Texas , P.a.

  • Specialist
  • San Antonio, TX
  • NPI 1275759540
  NPD (past)
• Riverwalk Clinic, LLC

  dba Alamo City Medical Group

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1629191176

  Family Medicine

  NPD (past)
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1750382503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NW LOOP 410 STE 100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132220",
            "telephone_number": "210-886-8031",
            "fax_number": "210-886-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NW LOOP 410 STE 100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132220",
            "telephone_number": "210-886-8031",
            "fax_number": "210-886-8059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9522 Huebner Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782401548",
            "country_code": "US",
            "telephone_number": "210-886-8031",
            "fax_number": "210-886-8059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCZYGEMBA",
        "first_name": "ROGER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J2212",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J2212",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "J2212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "J2212",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moc San Antonio II LLC (Rapid Recovery Center of San Antonio)
• Steffany Lea Mock, PA-C
• Mockingbird Optical Shop LLC
• Julie Elaine Moczygemba, PHYSICIAN ASSISTANT
• Marsha D Moczygemba, LVN
• Rudolph Moczygemba, RRT
• Shelby Marie Moczygemba, PT, DPT
• Valerie J Moczygemba, LPC
• Modelohz Association
• Modern Dental Professionals San Antonio PC (Castle Dental)

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.