Individual provider Active NPI

Barry M Moretzky,, D.M.D

  • Dentist
  • New York, NY
National Provider Identifier
1962619445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041076 Issued in NY
Practice address
295 Madison Ave # 28FLR
New York, NY 10017-6304
Phone
(212) 697-2929
Fax
(212) 697-0479
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 041076 NY Primary

Addresses

Primary practice location

295 Madison Ave # 28FLR
New York, NY 10017-6304

Mailing address

295 Madison Ave # 28FLR
New York, NY 10017-6304
Phone (212) 697-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160607000952 CT Order and Referring Only - DentistPractitioner - Dentist 4486944246

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962619445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 MADISON AVE # 28FLR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176304",
            "telephone_number": "212-697-2929",
            "fax_number": "212-697-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MADISON AVE # 28FLR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176304",
            "telephone_number": "212-697-2929",
            "fax_number": "212-697-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETZKY,",
        "first_name": "BARRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.