Active NPI
Justin Jonathan Mowchun, MD
- Neurology Physician
- Lebanon, NH
National Provider Identifier
1780782912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 13876
- Practice address
- 1 Medical Center Dr
Neurology
Lebanon, NH 03756-1000 - Phone
- (603) 650-5104
- Fax
- (603) 650-6233
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 0420011728 | VT | |
| Neurology Physician | 2084N0400X | 13876 | NH | Primary |
| Neurocritical Care Physician | 2084A2900X | 13876 | NH |
Addresses
Primary practice location
1 Medical Center Dr
Neurology
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Neurology
Lebanon, NH 03756-1000
Phone (603) 650-5104
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1016504 | Medicaid | VT | |
| 3079142 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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 100
- Quality
- 53.51
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.66 of 100
- Quality
- 53.51
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420011728 | VT | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Hitchcock Memorial Hospital | Current | Accepting new patients | |
| Dartmouth-Hitchcock Clinic | Current | Accepting new patients | |
| Mary Hitchcock Memorial Hospital | Current | Accepting new patients |
Locations
1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922
1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638
Interoperability endpoints
- jmowchun15193@direct.dartmouth-hitchcock.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Lebanon, NH
- NPI 1548210198
-
- General Acute Care Hospital
- Lebanon, NH
- NPI 1023092053
-
- Psychiatric Hospital
- Hampstead, NH
- NPI 1699584219
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lebanon, NH
- NPI 1023092053
-
- General Acute Care Hospital
- Lebanon, NH
- NPI 1629788237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476403200000",
"number": "1780782912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "NEUROLOGY",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5104",
"fax_number": "603-650-6233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "NEUROLOGY",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5104",
"fax_number": "603-650-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOWCHUN",
"first_name": "JUSTIN",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2016-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "VT",
"license": "0420011728",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NH",
"license": "13876",
"primary": true
},
{
"code": "2084A2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurocritical Care",
"state": "NH",
"license": "13876",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1016504",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3079142",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.