Individual provider Active NPI

Thomas A Moser, O.D.

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1821301029
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1750 Issued in AZ
Practice address
1423 S Higley Rd
Ste 127
Mesa, AZ 85206-3429
Phone
(480) 505-6206
Fax
(480) 505-6225
NPI assigned
Jul 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1750 AZ Primary

Addresses

Primary practice location

1423 S Higley Rd
Ste 127
Mesa, AZ 85206-3429

Mailing address

1024 N Constellation Way
Gilbert, AZ 85234-3902
Phone (614) 805-0487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150216000281 NE Practitioner - Optometry 3476746488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Family Vision Clinic LLCGroup PAC ID 8628393915, 3 clinicians

Practice addresses (Care Compare)

212 W 9TH St
MC Cook, NE 69001-3515
Phone (308) 345-2954

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1750AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
My Family Vision Clinic LLC Optometrist CurrentSince Dec 2, 2014 Accepting new patients
Burrows Vision Clinic LLC Optometrist PastSince Jan 1, 2015 Accepting new patients
Tom Sowash OD & Associates PC Optometrist Past Accepting new patients
Visionworks Inc Past Accepting new patients

Locations

212 W 9th St
McCook, NE 69001
Phone (308) 345-2954

Organizations & group practices 4

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1821301029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 N CONSTELLATION WAY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343902",
            "telephone_number": "614-805-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 S HIGLEY RD",
            "address_2": "STE 127",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063429",
            "telephone_number": "480-505-6206",
            "fax_number": "480-505-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.