Active NPI
Melissa Meyers Moen, M.D.
- Obstetrics & Gynecology Physician
- Arnold, MD
National Provider Identifier
1871646828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- D0034626
- Practice address
- 150 Glen Oban Dr
Arnold, MD 21012-2105 - Phone
- (410) 693-9183
- NPI assigned
- Jan 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | D0034626 | MD | Primary |
Addresses
Primary practice location
150 Glen Oban Dr
Arnold, MD 21012-2105
Mailing address
150 Glen Oban Dr
Arnold, MD 21012-2105
Phone (410) 693-9183
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11670003 | Other | DC | BSNCABSF |
| 484591900 | Medicaid | MD | |
| 1212271 | Other | MD | UHCARE |
| 225047 | Other | MD | MAMALP |
| 41817701 | Other | MD | BSBSPPO |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0034626 | MD | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1871646828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 GLEN OBAN DR",
"city": "ARNOLD",
"state": "MD",
"postal_code": "210122105",
"telephone_number": "410-693-9183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GLEN OBAN DR",
"city": "ARNOLD",
"state": "MD",
"postal_code": "210122105",
"telephone_number": "410-693-9183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEN",
"first_name": "MELISSA",
"middle_name": "MEYERS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-20",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MD",
"license": "D0034626",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNCABSF",
"identifier": "11670003",
"state": "DC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "484591900",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHCARE",
"identifier": "1212271",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMALP",
"identifier": "225047",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSBSPPO",
"identifier": "41817701",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arnold, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.