Moshe D Roberts, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

299492 Issued in NY

Practice address

6700 Kirkville Rd
Suite a
East Syracuse, NY 13057-9305

Phone

(315) 463-2013

Fax

(315) 463-2019

NPI assigned

Apr 15, 2016

Last updated

Mar 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mosheroberts@chca.medentdirect.com
• Direct secure messaging: mroberts56890@direct.upstate.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Upstate Emergency Medicine, Inc

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1275589582
  Medicare reassignment NPD
• Child Health Care Associates Practice of Pediatrics

  • Pediatrics Physician
  • East Syracuse, NY
  • NPI 1255463964
  NPD

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1881048999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 KIRKVILLE RD",
            "address_2": "SUITE A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579305",
            "telephone_number": "315-463-2013",
            "fax_number": "315-463-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 KIRKVILLE RD",
            "address_2": "SUITE A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579305",
            "telephone_number": "315-463-2013",
            "fax_number": "315-463-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MOSHE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "299492",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "299492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05665256",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerrod Christian Richards, RPH
• Kevin Howard Ridgeway, PHARM.D.
• Rite Aid of New York Inc (Rite Aid Pharmacy 03424)
• Robert C Cupelo MD PLLC
• Christine Lee Roberts, OTR
• Mya D Robertson, NP
• Brittney Murphy Robideau, SCHOOL PSYCHOLOGIST
• Erika Robinson, LMT
• Alexandra Rockhill, OTR/L
• Joyce Rode, RD

• Pediatrics Physician in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.