Individual provider Active NPI

Thomas G. Mooney, M.D.

  • Nephrology Physician
  • Lafayette, CO
National Provider Identifier
1952392136
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35172 Issued in CO
Practice address
2655 Crescent Dr
Suite C
Lafayette, CO 80026-3372
Phone
(303) 443-4200
Fax
(303) 443-5470
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35172 CO Primary

Addresses

Primary practice location

2655 Crescent Dr
Suite C
Lafayette, CO 80026-3372

Mailing address

4891 Independence St
Suite 120
Wheat Ridge, CO 80033-6752
Phone (303) 456-5495

Other identifiers 2

IdentifierTypeStateIssuer
390005667OtherCORR MEDICARE
01351725MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35172COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology PastSince Sep 20, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHACA

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1952392136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4891 INDEPENDENCE ST",
            "address_2": "SUITE 120",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336752",
            "telephone_number": "303-456-5495",
            "fax_number": "303-456-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 CRESCENT DR",
            "address_2": "SUITE C",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263372",
            "telephone_number": "303-443-4200",
            "fax_number": "303-443-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "THOMAS",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "35172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "390005667",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01351725",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.