Active NPI
Surinder Moonga, MD
- Psychiatry Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0092816
- Practice address
- 6501 N Charles St
Baltimore, MD 21204-6819 - Phone
- (410) 938-3000
- NPI assigned
- Apr 12, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A195179 | CA | |
| Psychiatry Physician | 2084P0800X | D0092816 | MD | Primary |
Addresses
Primary practice location
6501 N Charles St
Baltimore, MD 21204-6819
Mailing address
6501 N Charles St
Baltimore, MD 21204-6819
Phone (410) 938-3000
Other practice location 1
1162 Montgomery Dr Ste 200
Santa Rosa, CA 95405-4802
Phone (707) 890-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1162 Montgomery Dr
Suite 200
Santa Rosa, CA 95405-4802
Phone (707) 890-4100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A195179 | CA | MD | Psychiatry Physician |
| D0092816 | MD | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850
1162 Montgomery Dr
Ste 200
Santa Rosa, CA 95405
Phone (707) 890-4100
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
1209 N Charles St
Baltimore, MD 21201
100 N Academy Ave
Danville, PA 17822
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- smoonga3342919@oc.providencedirect.org
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- Obstetrics & Gynecology Physician
- Napa, CA
- NPI 1205131950
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713225600000",
"number": "1851898019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6501 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212046819",
"telephone_number": "410-938-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212046819",
"telephone_number": "410-938-3000"
}
],
"practiceLocations": [
{
"address_1": "1162 Montgomery Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Santa Rosa",
"state": "CA",
"postal_code": "954054802",
"country_code": "US",
"telephone_number": "707-890-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOONGA",
"first_name": "SURINDER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-12",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A195179",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0092816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.