Active NPI
Adriana Guzman De Moya, M.D.
- Pediatrics Physician
- Milwaukee, WI
National Provider Identifier
1871544882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 68466-20
- Practice address
- 1432 W Forest Home Ave
Milwaukee, WI 53204-3228 - Phone
- (414) 567-5400
- Fax
- (414) 567-5359
- NPI assigned
- May 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 68466-20 | WI | Primary |
Addresses
Primary practice location
1432 W Forest Home Ave
Milwaukee, WI 53204-3228
Mailing address
9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871544882 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68466-20 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Medical Group | Pediatrics | Past | Accepting new patients |
| Children's Medical Group | Pediatrics | Past | Accepting new patients |
| University of Miami | Pediatrics | Past | Accepting new patients |
| University of Miami | Past | Accepting new patients |
Interoperability endpoints
- ademoya60941@direct.chw.org
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.
-
dba Forest Home Pediatrics
- Pediatrics Physician
- Milwaukee, WI
- NPI 1821738261
-
dba UMiami Medicine - Pedi Critical Care
- Pediatric Critical Care Medicine Physician
- Miami, FL
- NPI 1356391106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1871544882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE # MS 958",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-7615",
"fax_number": "414-266-6238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1432 W FOREST HOME AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532043228",
"telephone_number": "414-567-5400",
"fax_number": "414-567-5359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MOYA",
"first_name": "ADRIANA",
"middle_name": "GUZMAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-14",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "68466-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871544882",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.