Individual provider Active NPI

Robert Franklin Moreland Jr., M.D.

  • Dermatology Physician
  • Anchorage, AK
National Provider Identifier
1790712842
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
5020 Issued in AK
Practice address
3841 Piper St Ste T4-020
Anchorage, AK 99508-4673
Phone
(907) 646-8500
Fax
(907) 646-9760
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5020 AK Primary

Addresses

Primary practice location

3841 Piper St Ste T4-020
Anchorage, AK 99508-4673

Mailing address

3841 Piper Street
Suite T4-020
Anchorage, AK 99508
Phone (907) 646-8500

Other identifiers 1

IdentifierTypeStateIssuer
MD2505MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20051027001208 AK Practitioner - Dermatology 3870510977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at San Antonio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

3841 Piper St
Suite T4 020
Anchorage, AK 99508-4673
Phone (907) 646-8500

Hospital & facility affiliations

  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision54
Removal of skin lesions1441
Removal or shaving of skin growth22
Skin biopsy379

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5020AKMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Derm - Blackhart PLLC Dermatology CurrentSince Oct 1, 2019 Accepting new patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Oct 1, 2019 Accepting new patients
Dermatology Associates,P.C. Past Accepting new patients

Locations

188 W Northern Lights Blvd
Ste 800
Anchorage, AK 99503
Phone (907) 276-2803

3841 Piper St
Ste T4-020
Anchorage, AK 99508
Phone (907) 646-8500

3841 Piper St
Ste 20
Anchorage, AK 99508
Phone (907) 646-8500

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.

Hospital & facility affiliations 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1790712842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 PIPER STREET",
            "address_2": "SUITE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-646-8500",
            "fax_number": "907-646-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-646-8500",
            "fax_number": "907-646-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "ROBERT",
        "middle_name": "FRANKLIN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AK",
            "license": "5020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2505",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.