Individual provider Active NPI

Marcos Antonio Moreno, MD

  • Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1801476320
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
75211 Issued in CT
Practice address
300 George St Ste 901
New Haven, CT 06511-6662
Phone
(203) 785-2095
NPI assigned
Apr 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 1023326 MA
Psychiatry Physician 2084P0800X 75211 CT Primary

Addresses

Primary practice location

300 George St Ste 901
New Haven, CT 06511-6662

Mailing address

300 George St Ste 901
New Haven, CT 06511-6662
Phone (203) 785-2095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250527000719 CT Practitioner - Psychiatry 6800276809 Reassigns benefits to 1 organization
I20250620002590 MA Practitioner - Psychiatry 6800276809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of North Dakota School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75211CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2025 Accepting new patients
Yale University Psychiatry Current Accepting new patients
Cambridge Public Health Commission Current Accepting new patients
Yale University CurrentSince Jul 1, 2025 Accepting new patients
Cambridge Public Health Commission CurrentSince Jul 31, 2025 Accepting new patients
Cambridge Public Health Commission CurrentSince Jul 31, 2025 Accepting new patients
Emerson Practice Associates, Inc. CurrentSince Apr 25, 2025 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

Interoperability endpoints

  • Direct secure messaging: mmoreno125099@direct.challiance.masshiway.net
  • Direct secure messaging: mmoreno515235@direct.ynhh.org

Organizations & group practices 7

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 3

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1801476320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST STE 901",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116662",
            "telephone_number": "203-785-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST STE 901",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116662",
            "telephone_number": "203-785-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MARCOS",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "1023326",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "75211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.