Individual provider Active NPI

Maitham Ammory Moslim Moslim, M.D.

  • Surgical Oncology Physician
  • Rochester, NY
National Provider Identifier
1871932822
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
337815 Issued in NY
Practice address
1415 Portland Ave Ste 245
Rochester, NY 14621-3022
Phone
(585) 922-5973
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35127433 OH
Surgery Physician 208600000X 337815 NY
Surgical Oncology Physician 2086X0206X 337815 NY Primary

Addresses

Primary practice location

1415 Portland Ave Ste 245
Rochester, NY 14621-3022

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

12623 Eckel Junction Rd Ste 2600
Perrysburg, OH 43551-1304
Phone (567) 368-1490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WI, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190430001288 OH Practitioner - General Surgery 0547562662 Reassigns benefits to 1 organization
I20240207002123 WI Practitioner - General Surgery 0547562662 Reassigns benefits to 1 organization
I20250703002213 NY Practitioner - Surgical Oncology 0547562662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1415 Portland Ave
Rochester, NY 14621-3038
Phone (585) 922-0390

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

Final score
91.7 of 100Reported as group
Quality
91.14
Promoting interoperability
100
Improvement activities
40
Cost
77.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
337815NYMDSurgery Physician
35127433OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Surgery CurrentSince Jun 30, 2025 Accepting new patients
Rochester General Hospital Current Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Aug 31, 2022 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Surgery CurrentSince Aug 31, 2022 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Rochester General Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1415 Portland Ave
Rochester, NY 14621
Phone (585) 275-7741

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Ste 245
Rochester, NY 14621
Phone (585) 922-4715

12623 Eckel Junction Rd
Perrysburg, OH 43551
Phone (567) 368-1434

12623 Eckel Junction Rd
Ste 2600
Perrysburg, OH 43551
Phone (567) 368-1490

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Interoperability endpoints

  • Direct secure messaging: mmoslim419257@direct.rochesterregional.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1871932822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PORTLAND AVE STE 245",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213022",
            "telephone_number": "585-922-5973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12623 Eckel Junction Rd Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "435511304",
            "country_code": "US",
            "telephone_number": "567-368-1490",
            "fax_number": "567-368-1478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLIM",
        "first_name": "MAITHAM",
        "middle_name": "AMMORY MOSLIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35127433",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "337815",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "337815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.