Individual provider Active NPI

Jesse Moss Jr., M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Live Oak, TX
National Provider Identifier
1851399463
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
H3795 Issued in TX
Practice address
12602 Toepperwein Rd
Suite 211
Live Oak, TX 78233-3269
Phone
(210) 656-8888
Fax
(210) 656-2608
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X H3795 TX Primary

Addresses

Primary practice location

12602 Toepperwein Rd
Suite 211
Live Oak, TX 78233-3269

Mailing address

12602 Toepperwein Rd
Suite 211
Live Oak, TX 78233-3269
Phone (210) 656-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040827000451 TX Practitioner - Otolaryngology 6103804281 Reassigns benefits to 1 organization
Practice locations: Live Oak, TX

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monty V. Trimble , MD, P.aGroup PAC ID 7517046451, 6 clinicians

Practice addresses (Care Compare)

12602 Toepperwein Rd
Suite 211
Live Oak, TX 78233-3271
Phone (210) 656-8888

3455 Locke Ave
Fort Worth, TX 76107-5719
Phone (817) 529-6200

3455 Locke Ave
Suite 210
Fort Worth, TX 76107-5747

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North East San Antonio Hearing & Balance L.L.C. PastSince Jun 1, 2004 Accepting new patients
Jesse Moss Jr Mdpa PastSince Jan 1, 1990 Accepting new patients
Christus Santa Rosa Outpatient Surgery - New Braunfels, LP PastSince Jul 13, 2004 Accepting new patients

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1851399463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12602 TOEPPERWEIN RD",
            "address_2": "SUITE 211",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333269",
            "telephone_number": "210-656-8888",
            "fax_number": "210-656-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12602 TOEPPERWEIN RD",
            "address_2": "SUITE 211",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333269",
            "telephone_number": "210-656-8888",
            "fax_number": "210-656-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "H3795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.