Active NPI
Ross Ryan Moquin, M.D.
- Neurological Surgery Physician
- Syracuse, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 240707
- Practice address
- 739 Irving Ave Ste 600
Syracuse, NY 13210-1663 - Phone
- (315) 701-2550
- Fax
- (315) 701-2551
- NPI assigned
- Jun 14, 2005
- Last updated
- Mar 12, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 240707 | NY | Primary |
Addresses
Primary practice location
739 Irving Ave Ste 600
Syracuse, NY 13210-1663
Mailing address
1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 475-3999
Other practice location 1
475 Irving Ave
Suite 418
Syracuse, NY 13210-1756
Phone (315) 475-3999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02809254 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rmoquin@crousemed.medentdirect.com | Direct | Crouse Medical Practice, PLLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurosurgical Associates of Central New York, LLP | Current | Accepting new patients | |
| Upstate Neurosurgery LLP | Neurological Surgery | Current | Accepting new patients |
| Guy W. Gargour, M.D., P.a. | Neurological Surgery | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Crouse Medical Practice PLLC | Past | Accepting new patients | |
| Guy W. Gargour, M.D., P.a. | Neurological Surgery | Past | Accepting new patients |
Locations
4900 Broad Rd
Ste 1352
Syracuse, NY 13215
Phone (315) 464-4470
Organizations & group practices 6
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.
-
- Neurological Surgery Physician
- Syracuse, NY
- NPI 1497788574
-
- Durable Medical Equipment & Medical Supplies
- Syracuse, NY
- NPI 1346384435
-
dba Internist Associates of Central New York Clinical Laboratories
- Clinical Medical Laboratory
- Syracuse, NY
- NPI 1548579212
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
dba Potomac Neurosurgery
- Neurological Surgery Physician
- Clinton, MD
- NPI 1427091412
-
- Neurological Surgery Physician
- Prince Frederick, MD
- NPI 1619165818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1821093279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 W FAYETTE ST",
"address_2": "SUITE 400",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132042859",
"telephone_number": "315-475-3999",
"fax_number": "315-470-4014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "739 IRVING AVE STE 600",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101663",
"telephone_number": "315-701-2550",
"fax_number": "315-701-2551"
}
],
"practiceLocations": [
{
"address_1": "475 Irving Ave",
"address_2": "Suite 418",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "NY",
"postal_code": "132101756",
"country_code": "US",
"telephone_number": "315-475-3999",
"fax_number": "315-470-4014",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOQUIN",
"first_name": "ROSS",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NY",
"license": "240707",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02809254",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rmoquin@crousemed.medentdirect.com",
"affiliation": "Y",
"endpointDescription": "email address in Medent",
"affiliationName": "Crouse Medical Practice, PLLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "other",
"address_1": "739 Irving Ave Ste 600",
"city": "Syracuse",
"state": "NY",
"country_code": "US",
"postal_code": "132101663",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.