Individual provider Active NPI

Myriam Mercedes Claudio Moser, P.T., D.P.T.

  • Physical Therapist
  • Wilmington, MA
National Provider Identifier
1912444159
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18359 Issued in MA
Practice address
230 Lowell Street
Suite 2D
Wilmington, MA 01887
Phone
(978) 657-7404
NPI assigned
Jan 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18359 MA Primary

Addresses

Primary practice location

230 Lowell Street
Suite 2D
Wilmington, MA 01887

Mailing address

230 Lowell Street
Suite 2D
Wilmington, MA 01887
Phone (978) 657-7404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170316001922 MA Practitioner - Physical Therapist in Private Practice 2567747439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leonardo Physical TherapyGroup PAC ID 7012056286, 5 clinicians

Practice addresses (Care Compare)

230 Lowell St
Suite 2D
Wilmington, MA 01887-3088
Phone (978) 657-7404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18359MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Leonardo Physical Therapy Physical Therapist CurrentSince Feb 2, 2017 Accepting new patients

Locations

230 Lowell St
Ste 2D
Wilmington, MA 01887
Phone (978) 657-7404

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": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1912444159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 LOWELL STREET",
            "address_2": "SUITE 2D",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "01887",
            "telephone_number": "978-657-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 LOWELL STREET",
            "address_2": "SUITE 2D",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "01887",
            "telephone_number": "978-657-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "MYRIAM",
        "middle_name": "MERCEDES CLAUDIO",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.