Individual provider Active NPI

Alan S Moak, MD

  • Interventional Cardiology Physician
  • Philadelphia, PA
National Provider Identifier
1912939216
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD035678E Issued in PA
Practice address
39TH and Market St
4 Phi
Philadelphia, PA 19104
Phone
(215) 662-9000
Fax
(215) 243-4611
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD035678E PA Primary

Addresses

Primary practice location

39TH and Market St
4 Phi
Philadelphia, PA 19104

Mailing address

51 N 39TH St
4 Phi
Philadelphia, PA 19104-2640
Phone (215) 662-9189

Other identifiers 1

IdentifierTypeStateIssuer
0008434220002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040607000195 NJ Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3577545193 Reassigns benefits to 1 organization
I20050203000366 PA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3577545193 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jul 1, 2002 Accepting new patients
Clinical Health Care Associates of New Jersey PC Interventional Cardiology CurrentSince Jul 1, 2002 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jul 1, 2002 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Mainland Heart Consultants Past Accepting new patients
Lourdes Cardiology Services Past Accepting new patients

Locations

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

211 S Main St
Ste 205
Cape May Court House, NJ 08210
Phone (609) 463-0800

409 Route 70 E
Cherry Hill, NJ 08034
Phone (856) 427-4336

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

2051 Briggs Rd
Mount Laurel, NJ 08054
Phone (856) 234-3332

1503 Lansdowne Ave
Ste 3001
Darby, PA 19023
Phone (610) 586-4100

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

Organizations & group practices 6

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1912939216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "4 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39TH AND MARKET ST",
            "address_2": "4 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-9000",
            "fax_number": "215-243-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "ALAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD035678E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008434220002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.