Individual provider Active NPI

James Michael Moses, MD

  • Pediatrics Physician
  • Grand Rapids, MI
National Provider Identifier
1912998683
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301503980 Issued in MI
Practice address
100 Michigan St NE # Mc169
Grand Rapids, MI 49503-2560
Phone
(616) 267-0118
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301503980 MI Primary

Addresses

Primary practice location

100 Michigan St NE # Mc169
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210504000897 MI Practitioner - Pediatric Medicine 0547202509 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223430MAMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jun 1, 2021 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 1, 2021 Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. Past Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics PastSince Oct 22, 2023 Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

100 Michigan St NE
Rm 280
Grand Rapids, MI 49503
Phone (616) 267-0115

100 Michigan St NE
#169
Grand Rapids, MI 49503
Phone (616) 267-0118

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: jmoses286799@epic00.corewelldirect.org

Organizations & group practices 4

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1912998683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC169",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-267-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301503980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.