NPIMap

Organization Active NPI

Moments Palliative Care LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Des Plaines, IL
National Provider Identifier
1972290724
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
MOMENTS PALLIATIVE CARE LLC
Practice address
2860 S River Rd Ste 160
Des Plaines, IL 60018-6006
Phone
(773) 798-6741
Fax
(702) 977-1496
NPI assigned
Apr 21, 2023
Last updated
Dec 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MOMENTS PALLIATIVE CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Eliyahu Jaffa
Title
President
Phone
(612) 655-5242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

2860 S River Rd Ste 160
Des Plaines, IL 60018-6006

Mailing address

820 Lilac Dr N Ste 210
Golden Valley, MN 55422-4754
Phone (763) 205-3600

Other practice location 1

545 Plainfield Rd Ste G-1
Willowbrook, IL 60527-7600
Phone (708) 405-8025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230621000073 IL Part B Supplier - Clinic/Group Practice 0143561480 Receives reassigned benefits from 5 practitioners
Practice locations: Des Plaines, IL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Moments Palliative Care LLC3 organizations share this tax ID, including this one
Part of
Moments Palliative Care LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1972290724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N STE 210",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224754",
            "telephone_number": "763-205-3600",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S RIVER RD STE 160",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600186006",
            "telephone_number": "773-798-6741",
            "fax_number": "702-977-1496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Plainfield Rd Ste G-1",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605277600",
            "country_code": "US",
            "telephone_number": "708-405-8025",
            "fax_number": "702-977-1496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOMENTS PALLIATIVE CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOMENTS PALLIATIVE CARE LLC",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "JAFFA",
        "authorized_official_first_name": "ELIYAHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-655-5242"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.