Individual provider Active NPI

Nicole Dorothy Moses, MD

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1881801322
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036121468 Issued in IL
Practice address
135 N Oak St
Hinsdale, IL 60521-3860
Phone
(630) 856-8900
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036121468 IL Primary

Addresses

Primary practice location

135 N Oak St
Hinsdale, IL 60521-3860

Mailing address

135 N Oak St
Hinsdale, IL 60521-3860

Other identifiers 1

IdentifierTypeStateIssuer
821050OtherILPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20161027001477 ID Practitioner - Family Practice 9133281512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Full Circle Health IncGroup PAC ID 6709986797, 106 clinicians

Practice addresses (Care Compare)

215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 514-2529

777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500

9850 W St Lukes Dr
Suite 329
Nampa, ID 83687-7912
Phone (208) 514-2509

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Health, Inc. CurrentSince Nov 18, 2020 Accepting new patients

Locations

777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030

9850 W St Lukes Dr
Ste 329
Nampa, ID 83687
Phone (208) 331-1155

Interoperability endpoints

  • Direct secure messaging: nmoses324931@direct.ochin.org

Organizations & group practices 1

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1881801322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213860",
            "telephone_number": "630-856-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "NICOLE",
        "middle_name": "DOROTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036121468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "821050",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.