Active NPI
Nicole Juliana Moss, MD
- Obstetrics & Gynecology Physician
- Las Vegas, NV
National Provider Identifier
1821060856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 9708
- Practice address
- 2931 N Tenaya Way
Suite 204
Las Vegas, NV 89128-0456 - Phone
- (702) 233-2123
- Fax
- (702) 233-0398
- NPI assigned
- Feb 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 9708 | NV | Primary |
Addresses
Primary practice location
2931 N Tenaya Way
Suite 204
Las Vegas, NV 89128-0456
Mailing address
2931 N Tenaya Way
Suite 204
Las Vegas, NV 89128-0456
Phone (702) 233-2123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2018759 | Medicaid | NV | |
| 3102759 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2012 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9708 | NV | MD | Obstetrics & Gynecology Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Obstetrics & Gynecology Physician
- Las Vegas, NV
- NPI 1952589541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1821060856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2931 N TENAYA WAY",
"address_2": "SUITE 204",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280456",
"telephone_number": "702-233-2123",
"fax_number": "702-233-0398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2931 N TENAYA WAY",
"address_2": "SUITE 204",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280456",
"telephone_number": "702-233-2123",
"fax_number": "702-233-0398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "NICOLE",
"middle_name": "JULIANA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NV",
"license": "9708",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2018759",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3102759",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.