Individual provider Active NPI

Maria A Moogerfeld, M.D.

  • Internal Medicine Physician
  • Statesboro, GA
National Provider Identifier
1750439436
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
051893 Issued in GA
Practice address
1088A Bermuda Run
Statesboro, GA 30458-0858
Phone
(912) 681-7111
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 051893 GA Primary

Addresses

Primary practice location

1088A Bermuda Run
Statesboro, GA 30458-0858

Mailing address

1449 Brampton Ave
Statesboro, GA 30458-0854
Phone (912) 681-7111

Other identifiers 3

IdentifierTypeStateIssuer
754283113AMedicaidGA
754283113BMedicaidGA
52841448OtherGABCBS GEORGIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address maria.moogerfeld.1@8824.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040909001277 GA Practitioner - Internal Medicine 0941276901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Georgia Hma Physician Management LLCGroup PAC ID 7214068592, 42 clinicians

Practice addresses (Care Compare)

1449 Brampton Ave
Statesboro, GA 30458-0854
Phone (912) 486-1163

1497 Fair Rd
Statesboro, GA 30458-0823

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.68 of 100Reported as apm
Quality
76.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Georgia Hma Physician Management, LLC Internal Medicine CurrentSince Nov 1, 2020 Accepting new patients
Brian a Moogerfeld MD, LLC Internal Medicine Past Accepting new patients

Locations

1449 Brampton Ave
Statesboro, GA 30458
Phone (912) 486-1163

1497 Fair Rd
Ste 103
Statesboro, GA 30458
Phone (912) 486-1163

Interoperability endpoints

  • Direct secure messaging: maria.moogerfeld.1@8824.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1750439436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580854",
            "telephone_number": "912-681-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088A BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-681-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOGERFELD",
        "first_name": "MARIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "754283113A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "754283113B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GEORGIA",
            "identifier": "52841448",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maria.moogerfeld.1@8824.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1449 Brampton Ave",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304580854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.