Individual provider Active NPI

Rex Edward Moulton-Barrett, M.D.

  • Specialist
  • Alameda, CA
National Provider Identifier
1770648057
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A45787 Issued in CA
Practice address
2070 Clinton Ave FL 4
Alameda, CA 94501-4399
Phone
(510) 864-1800
Fax
(510) 864-1180
NPI assigned
Dec 27, 2006
Last updated
Mar 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A45787 CA Primary

Addresses

Primary practice location

2070 Clinton Ave FL 4
Alameda, CA 94501-4399

Mailing address

2070 Clinton Ave FL 4
Alameda, CA 94501-4399
Phone (510) 864-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20091207000040 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - OtolaryngologyPractitioner - Hand Surgery 1759420615

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45787CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital & Research Center at Oakland Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Alameda Health System Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rmoultonbarrett@directaddress.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1770648057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE FL 4",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014399",
            "telephone_number": "510-864-1800",
            "fax_number": "510-864-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE FL 4",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014399",
            "telephone_number": "510-864-1800",
            "fax_number": "510-864-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON-BARRETT",
        "first_name": "REX",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A45787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.