Individual provider Active NPI

Giovanna Marie Moses, O.D.

  • Optometrist
  • Delavan, WI
National Provider Identifier
1942259171
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2918-035 Issued in WI
Practice address
1221 Phoenix St
Delavan, WI 53115-2340
Phone
(262) 728-2667
Fax
(262) 728-3539
NPI assigned
May 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2918-035 WI Primary

Addresses

Primary practice location

1221 Phoenix St
Delavan, WI 53115-2340

Mailing address

1221 Phoenix St
Delavan, WI 53115-2340
Phone (262) 728-2667

Other identifiers 1

IdentifierTypeStateIssuer
38629100MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060323000089 WI Practitioner - Optometry 7618985391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1221 Phoenix St
Delavan, WI 53115-2340
Phone (262) 728-2667

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2918-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Eye Clinic, SC Optometrist CurrentSince Dec 7, 2009 Accepting new patients

Locations

1221 Phoenix St
Delavan, WI 53115
Phone (262) 728-2667

Organizations & group practices 1

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1942259171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PHOENIX ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152340",
            "telephone_number": "262-728-2667",
            "fax_number": "262-728-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PHOENIX ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152340",
            "telephone_number": "262-728-2667",
            "fax_number": "262-728-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "GIOVANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2918-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38629100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delavan, WI

Sources for this page

Verify at the official NPI Registry.