Individual provider Active NPI

Gregory G Moss, LCSW

  • Clinical Social Worker
  • Cortland, NY
National Provider Identifier
1831154186
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R021387-1 Issued in NY
Practice address
84 N Main St
Suite 103
Cortland, NY 13045-2127
Phone
(607) 545-4532
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R021387-1 NY Primary

Addresses

Primary practice location

84 N Main St
Suite 103
Cortland, NY 13045-2127

Mailing address

84 N Main St
Suite 103
Cortland, NY 13045-2127
Phone (607) 545-4532

Other identifiers 1

IdentifierTypeStateIssuer
00021387MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000037 NY Practitioner - Clinical Social Worker 5294779039 Practice locations: Cortland, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

84 N Main St
Ofc 3
Cortland, NY 13045-2127
Phone (607) 545-4532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R021387-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1831154186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 N MAIN ST",
            "address_2": "SUITE 103",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452127",
            "telephone_number": "607-545-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 N MAIN ST",
            "address_2": "SUITE 103",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452127",
            "telephone_number": "607-545-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "GREGORY",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R021387-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00021387",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.