NPIMap

Individual provider Active NPI

Mario Moya, MD

  • Vascular & Interventional Radiology Physician
  • Newtown Square, PA
National Provider Identifier
1962470740
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
P3778 Issued in TX
Practice address
647 Malin Rd
Newtown Square, PA 19073-2621
Phone
(610) 908-2995
NPI assigned
Mar 9, 2006
Last updated
Sep 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD048581L PA
Vascular & Interventional Radiology Physician 2085R0204X MD048581L PA
Vascular & Interventional Radiology Physician 2085R0204X MD00048471 WA
Vascular & Interventional Radiology Physician 2085R0204X 25MA06785000 NJ
Vascular & Interventional Radiology Physician 2085R0204X P3778 TX Primary

Addresses

Primary practice location

647 Malin Rd
Newtown Square, PA 19073-2621

Mailing address

1400 Northgate LN
McAllen, TX 78504-9558
Phone (610) 908-2995

Other identifiers 2

IdentifierTypeStateIssuer
6895808MedicaidNJ
P00391336OtherNJRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120810000685 TX Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9739197245 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Medical FoundationGroup PAC ID 1153409867, 178 clinicians

Practice addresses (Care Compare)

1200 E Savannah Ave
Suite 3
McAllen, TX 78503-1728
Phone (956) 339-5867

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 362-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.1 of 100Reported as group
Quality
86
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD048581LPAMDDiagnostic Radiology Physician
25MA06785000NJMDVascular & Interventional Radiology Physician
P3778TXMDVascular & Interventional Radiology Physician
MD00048471WAMDVascular & Interventional Radiology Physician
55474CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Physician Services of South Texas CurrentSince Jul 1, 2024 Accepting new patients
Moya Innovative Vascular Services PLLC CurrentSince Aug 1, 2025 Accepting new patients
Renaissance Medical Foundation CurrentSince Aug 23, 2024 Accepting new patients
Children's Physician Services of South Texas CurrentSince Jul 1, 2024 Accepting new patients
Mymobilexray, PLLC CurrentSince Sep 4, 2022 Accepting new patients
Moya Home Health LLC Past Accepting new patients
Delco Radiologic Associates Diagnostic Radiology Past Accepting new patients
Open M.R.I of Chestnut Hill, L.L.C. Past Accepting new patients
Mario Moya MD PA Vascular & Interventional Radiology Past Accepting new patients
Vascular Access Center of Southwest Louisiana LLC Vascular & Interventional Radiology PastSince Sep 1, 2012 Accepting new patients
Northeast Open MRI, Inc PastSince Oct 1, 2019 Accepting new patients
Cardiothoracic & Vascular Surgical Associates PA Diagnostic Radiology Past Accepting new patients
American Access Care of Pennsylvania LLC PastSince May 10, 2020 Accepting new patients
Delaware County Open MRI L.L.C Past Accepting new patients
West Valley Radiology Diagnostic Radiology PastSince Apr 25, 2024 Accepting new patients
Vascular Access Center of Trenton LLC Vascular & Interventional Radiology PastSince Feb 1, 2017 Accepting new patients
James F McGuckin MD Inc Vascular & Interventional Radiology Past Accepting new patients
American Access Care of Pennsylvania LLC Vascular & Interventional Radiology PastSince Feb 21, 2021 Accepting new patients

Locations

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

1200 E Savannah Ave
Ste 3
McAllen, TX 78503
Phone (956) 328-0881

1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 6

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1962470740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NORTHGATE LN",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785049558",
            "telephone_number": "610-908-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 MALIN RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732621",
            "telephone_number": "610-908-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD048581L",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD048581L",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD00048471",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA06785000",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "P3778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6895808",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00391336",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

Verify at the official NPI Registry.