Active NPI
Moss Dermatology LLC
- Dermatology Physician
- Forest Hills, NY
National Provider Identifier
1780835918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 193984
- Legal business name
- MOSS DERMATOLOGY LLC
- Practice address
- 10840 Queens Blvd
Forest Hills, NY 11375-5361 - Phone
- (718) 268-3161
- Fax
- (718) 268-2311
- NPI assigned
- Oct 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tamara Moss, M.D.
- Title
- Physician
- Phone
- (718) 268-3161
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 193984 | NY | Primary |
Addresses
Primary practice location
10840 Queens Blvd
Forest Hills, NY 11375-5361
Mailing address
10840 Queens Blvd
Forest Hills, NY 11375-5361
Phone (718) 268-3161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
7410 Broadway
Ste 3
Elmhurst, NY 11373
Phone (718) 971-1340
10840 Queens Blvd
Forest Hills, NY 11375
Phone (718) 268-3161
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Forest Hills, NY
- NPI 1134143282
-
- Anatomic Pathology & Clinical Pathology Physician
- Brooklyn, NY
- NPI 1427285386
-
- Gastroenterology Physician
- Forest Hills, NY
- NPI 1538183678
-
- Pain Medicine (Anesthesiology) Physician
- Astoria, NY
- NPI 1114958717
-
- Anatomic Pathology & Clinical Pathology Physician
- Union, NJ
- NPI 1699968743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223337600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1429574400000",
"number": "1780835918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10840 QUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755361",
"telephone_number": "718-268-3161",
"fax_number": "718-268-2311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10840 QUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755361",
"telephone_number": "718-268-3161",
"fax_number": "718-268-2311"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOSS DERMATOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-07",
"last_updated": "2015-04-21",
"status": "A",
"authorized_official_last_name": "MOSS",
"authorized_official_first_name": "TAMARA",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "718-268-3161",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "NY",
"license": "193984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.