Individual provider Active NPI

Herbert J. Mosberg, M.D.

  • Obstetrics & Gynecology Physician
  • Hollis, NY
National Provider Identifier
1790751402
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
109340 Issued in NY
Practice address
18904 Hillside Ave
Hollis, NY 11423-1938
Phone
(718) 740-5545
Fax
(718) 740-1551
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 109340 NY Primary

Addresses

Primary practice location

18904 Hillside Ave
Hollis, NY 11423-1938

Mailing address

PO Box 27842
New York, NY 10087-7842
Phone (718) 670-1651

Other identifiers 1

IdentifierTypeStateIssuer
00241901MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109340NYMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1790751402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27842",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877842",
            "telephone_number": "718-670-1651",
            "fax_number": "718-740-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18904 HILLSIDE AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231938",
            "telephone_number": "718-740-5545",
            "fax_number": "718-740-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSBERG",
        "first_name": "HERBERT",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "109340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00241901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollis, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.