Individual provider Active NPI

Adelina Del Rosario Moya, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1942231469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
5455 W North Ave
Chicago, IL 60639-4346
Phone
(773) 889-0166
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

5455 W North Ave
Chicago, IL 60639-4346

Mailing address

416 Justina St
Hinsdale, IL 60521-2419
Phone (630) 655-0596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20061030000452 IL Practitioner - Family Practice 8628075926 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Humboldt Park HealthGroup PAC ID 8921907072, 106 clinicians

Practice addresses (Care Compare)

1044 N Mozart St
Suite 100
Chicago, IL 60622-3644
Phone (773) 292-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036067189ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt Park Health Family Medicine CurrentSince Apr 15, 2018 Accepting new patients
Munster Radiology Group PC Past Accepting new patients

Locations

1044 N Mozart St
Chicago, IL 60622
Phone (773) 292-8247

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1044 N Mozart St
Ste 100
Chicago, IL 60622
Phone (773) 292-8247

Interoperability endpoints

  • Direct secure messaging: amoya@direct-address.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942231469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 JUSTINA ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212419",
            "telephone_number": "630-655-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606394346",
            "telephone_number": "773-889-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "ADELINA",
        "middle_name": "DEL ROSARIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.