NPIMap

Individual provider Active NPI

Gary Stuart Moak, M.D.

  • Geriatric Psychiatry Physician
  • Lebanon, NH
National Provider Identifier
1760478473
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
8028 Issued in NH
Practice address
1 Medical Center Dr
Dartmouth Hitchcock - Psychiatry
Lebanon, NH 03756-1000
Phone
(603) 650-6150
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 56109 MA
Geriatric Psychiatry Physician 2084P0805X 56109 MA
Geriatric Psychiatry Physician 2084P0805X 8028 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Dartmouth Hitchcock - Psychiatry
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Dartmouth Hitchcock - Psychiatry
Lebanon, NH 03756-1000
Phone (603) 650-6150

Other identifiers 3

IdentifierTypeStateIssuer
3006816MedicaidMA
56109OtherMAMEDICAL LICENSE
J05608OtherMABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150902000609 NH Practitioner - Geriatric PsychiatryPractitioner - Psychiatry 7810974532 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric PsychiatryAlso: Psychiatry
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients
State of New Hampshire CurrentSince Dec 14, 2017 Accepting new patients
Cottage Hospital CurrentSince Jan 19, 2023 Accepting new patients
Cottage Hospital Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients
Cottage Hospital CurrentSince Jan 19, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jul 1, 2016 Accepting new patients
State of New Hampshire CurrentSince Dec 14, 2017 Accepting new patients

Locations

36 Clinton St
Concord, NH 03301
Phone (603) 271-5075

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

90 Swiftwater Rd
Woodsville, NH 03785
Phone (603) 747-9000

Interoperability endpoints

  • Direct secure messaging: gmoak176094@direct.dartmouth-hitchcock.org

Organizations & group practices 8

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 2

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1760478473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHIATRY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHIATRY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "GARY",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "56109",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MA",
            "license": "56109",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NH",
            "license": "8028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3006816",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "56109",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "J05608",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.