Individual provider Active NPI

Anne Moseley-Wiss, LICSW

  • Clinical Social Worker
  • Wayland, MA
National Provider Identifier
1932138054
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105678 Issued in MA
Practice address
7 3 Ponds Rd
Wayland, MA 01778-2008
Phone
(508) 859-4111
Fax
(978) 372-6736
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 105678 MA Primary

Addresses

Primary practice location

7 3 Ponds Rd
Wayland, MA 01778-2008

Mailing address

7 3 Ponds Rd
Wayland, MA 01778-2008
Phone (508) 358-2264

Other identifiers 1

IdentifierTypeStateIssuer
62-00196OtherMAEVERCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000704 MA Practitioner - Clinical Social Worker 8921024274 Practice locations: Wayland, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 Three Ponds Rd
Wayland, MA 01778-2008
Phone (508) 654-0211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1932138054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 3 PONDS RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017782008",
            "telephone_number": "508-358-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 3 PONDS RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017782008",
            "telephone_number": "508-859-4111",
            "fax_number": "978-372-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY-WISS",
        "first_name": "ANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "62-00196",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayland, MA

Sources for this page

Verify at the official NPI Registry.