Active NPI
Robert P.J. Moon
- Local Education Agency (LEA)
- Ronkonkoma, NY
National Provider Identifier
1861053027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Local Education Agency (LEA)
- Practice address
- 6 Mountain St
Ronkonkoma, NY 11779-1820 - Phone
- (631) 588-4017
- NPI assigned
- Jun 27, 2019
- Last updated
- Jun 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Local Education Agency (LEA) | 251300000X | NY | Primary |
Addresses
Primary practice location
6 Mountain St
Ronkonkoma, NY 11779-1820
Mailing address
72 Farmedge Rd
Levittown, NY 11756-5202
Phone (516) 921-7171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1861053027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 FARMEDGE RD",
"city": "LEVITTOWN",
"state": "NY",
"postal_code": "117565202",
"telephone_number": "516-921-7171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 MOUNTAIN ST",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117791820",
"telephone_number": "631-588-4017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "ROBERT",
"middle_name": "P.J.",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "251300000X",
"taxonomy_group": "",
"desc": "Local Education Agency (LEA)",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ronkonkoma, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.