David A Moeller, MD
Individual provider Active NPI Diagnostic Radiology Physician · Anchorage, AK
NPI 1891782074 · NPPES record last updated Jun 27, 2016
Key facts
- NPI
- 1891782074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 1767 (AK)
- Practice address
- 3200 Providence Dr
Anchorage, AK 99508-4661 - Phone
- (907) 339-9455
- Fax
- (907) 339-9445
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200221000508 | TX | Practitioner - Diagnostic Radiology | 0446154546 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Current |
Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients | |
| Maniilaq Association | Current |
Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients |
Interoperability endpoints
- ndmoeller@direct.nshcorp.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 1767 | AK | Yes |
Addresses
Primary practice location
3200 Providence Dr
Anchorage, AK 99508-4661
Mailing address
3650 Piper St
Ste a
Anchorage, AK 99508-4692
Phone (907) 339-9455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD1767 | Medicaid | AK |
Other providers in Anchorage, AK
- Jennifer Mock
- Eden Mockett
- Miriam Mockett
- Allison Phillips Moe
- Elizabeth Ann Moe
- Samantha Lynne Moffet
- Tyler Caphton Moffett
- Nazly Mofidi
- Sheila Moghaddassian
- Adan A Mohamed
All providers in Anchorage, AK · Diagnostic Radiology Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.