Individual provider Active NPI

Harjasrai S Moorjani, M.D.

  • Nephrology Physician
  • Orange City, FL
National Provider Identifier
1811984362
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME 67505 Issued in FL
Practice address
2877 Wellness Ave
Orange City, FL 32763-8396
Phone
(386) 668-4650
Fax
(386) 668-4649
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME 67505 FL Primary

Addresses

Primary practice location

2877 Wellness Ave
Orange City, FL 32763-8396

Mailing address

2877 Wellness Ave
Orange City, FL 32763-8396
Phone (386) 668-4650

Other identifiers 1

IdentifierTypeStateIssuer
250985700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090326000212 FL Practitioner - NephrologyPractitioner - Internal Medicine 0446316269 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 67505FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney and Hypertension Specialists PA CurrentSince Sep 1, 2008 Accepting new patients
Sleeshore Dialysis, LLC PastSince Sep 3, 2022 Accepting new patients
Vinayak V Purandare MD PL Nephrology Past Accepting new patients
Nephrology Consultants PA Past Accepting new patients
Daytona Beach Vascular Access, LLC PastSince May 28, 2023 Accepting new patients

Locations

2877 Wellness Ave
Orange City, FL 32763
Phone (386) 668-4650

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1811984362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2877 WELLNESS AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638396",
            "telephone_number": "386-668-4650",
            "fax_number": "386-668-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2877 WELLNESS AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638396",
            "telephone_number": "386-668-4650",
            "fax_number": "386-668-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORJANI",
        "first_name": "HARJASRAI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME 67505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250985700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.