Raul J Moreno, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0059679 Issued in FL

Practice address

2639 Oak St
Jacksonville, FL 32204-4505

Phone

(904) 387-5600

Fax

(904) 388-0114

NPI assigned

Jul 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, FL2 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

Specialty

Ophthalmology

Education

University of Puerto Rico School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Vitreous ConsultantsGroup PAC ID 4082610019, 43 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

99

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmoreno@floridaretinainstitute.intellechartdirect.net

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.

• Retina Vitreous Consultants

  dba Retina Group of Florida

  • Ophthalmology Physician
  • Fort Lauderdale, FL
  • NPI 1699773796

  GA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1932109659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8786 PERIMETER PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166347",
            "telephone_number": "904-997-9202",
            "fax_number": "904-996-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 OAK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044505",
            "telephone_number": "904-387-5600",
            "fax_number": "904-388-0114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8786 Perimeter Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322166347",
            "country_code": "US",
            "telephone_number": "904-997-9202",
            "fax_number": "904-997-9205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "304 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315014549",
            "country_code": "US",
            "telephone_number": "912-283-1400",
            "fax_number": "912-283-0019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3120 Glynn Ave",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315204848",
            "country_code": "US",
            "telephone_number": "912-262-9092",
            "fax_number": "912-466-0939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "RAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "34670",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "GA",
            "license": "34670",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME59679",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0059679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000464065A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056043000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmoreno@floridaretinainstitute.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "2639 Oak St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322044505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anita Moreno, LISW
• Fernando Moreno Jr., MD
• Jessica Christine Moreno, LMHC
• John Paul Moreno, PC
• Mary Ellen Moreno, BA
• Tomas Alejandro Moreno, MD
• Yessenia Franco Moreno, LCSW
• Jessica Natalie Morenus, APRN
• Chelsey Morera
• Jason A Moret, MD

• Ophthalmology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.