Moses Fallah, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00768800 Issued in NJ

Practice address

261 Connecticut Dr
Suite 5
Burlington, NJ 08016-4177

Phone

(800) 950-6066

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: moses.fallah@78655326388228.direct.elationemr.com

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.

• Simple Guidance

  • Community/Behavioral Health Agency
  • Willingboro, NJ
  • NPI 1770316465
  NPD Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1891900486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BEAVERDALE LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461612",
            "telephone_number": "609-481-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 CONNECTICUT DR",
            "address_2": "SUITE 5",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080164177",
            "telephone_number": "800-950-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLAH",
        "first_name": "MOSES",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR11629300-",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00768800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Burlington, NJ
• Providers in Burlington, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.