Mark Lee Moss, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 3018 Issued in ID

Practice address

390 E Parkcenter Blvd
Suite 130
Boise, ID 83706-6662

Phone

(208) 433-9211

Fax

(208) 433-9241

NPI assigned

Jul 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moss Physical Therapy LLCGroup PAC ID 4688065741, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Moss Physical Therapy LLC

  dba Hidden Springs Physical Therapy

  • Physical Therapy Clinic/Center
  • Boise, ID
  • NPI 1184297111

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Therapeutic Associates Inc

  dba TAI SE Boise

  • Physical Therapist
  • Boise, ID
  • NPI 1487630240
  Medicare reassignment NPD
• Therapeutic Associates Inc

  dba TAI - Nampa Physical Therapy

  • Physical Therapist
  • Nampa, ID
  • NPI 1174766158
  NPD
• Therapeutic Associates Inc

  dba TAI - Rock Creek

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Therapeutic Associates Inc

  dba TAI Boise Physical Therapy State Street

  • Physical Therapist
  • Boise, ID
  • NPI 1326024472
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1891050068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E PARKCENTER BLVD",
            "address_2": "SUITE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066662",
            "telephone_number": "208-433-9211",
            "fax_number": "208-433-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "MARK",
        "middle_name": "LEE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT 3018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "0330322",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891050068",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Elizabeth Mosher, C.F.N.P.
• Shannon Moskitis, LCSW
• Moss Physical Therapy LLC (Hidden Springs Physical Therapy)
• J Randall Moss, D.D.S.
• Janae Moss
• Motion Chiropractic PLLC
• Carla Motley
• Ali Astrid Moto, LMSW
• Freddy Moto
• Jill Moughamian, NP

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.