Individual provider Active NPI

Michael Jason Moks, OTR/L

  • Occupational Therapist
  • Delavan, WI
National Provider Identifier
1902356108
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5953-26 Issued in WI
Practice address
830 E Geneva St
Delavan, WI 53115-1932
Phone
(262) 728-9164
Fax
(262) 728-9172
NPI assigned
Oct 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5953-26 WI Primary

Addresses

Primary practice location

830 E Geneva St
Delavan, WI 53115-1932

Mailing address

830 E Geneva St
Delavan, WI 53115-1932
Phone (262) 728-9164

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204001672 WI Practitioner - Occupational Therapist in Private Practice 0345649521 Reassigns benefits to 9 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5953-26WIMDOccupational Therapist
5953WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Nov 25, 2024 Accepting new patients
Memorial Hospital Inc CurrentSince Nov 25, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Nov 25, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Nov 25, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Nov 25, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Nov 25, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Nov 25, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 25, 2024 Accepting new patients
Aurora Health Care Southern Lakes, Inc. Past Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 12

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1902356108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 E GENEVA ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151932",
            "telephone_number": "262-728-9164",
            "fax_number": "262-728-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 E GENEVA ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151932",
            "telephone_number": "262-728-9164",
            "fax_number": "262-728-9172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N OAK AVE",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "54449",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOKS",
        "first_name": "MICHAEL",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5953-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N OAK AVE",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delavan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.