Individual provider Active NPI

May Anisa Moayad, D.O.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1982068722
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T1467 Issued in TX
Practice address
2755 Miller Ave
Fort Worth, TX 76105-4164
Phone
(817) 534-7110
Fax
(817) 413-0521
NPI assigned
Apr 7, 2016
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X T1467 TX Primary
Pediatrics Physician 208000000X 312002 LA

Addresses

Primary practice location

2755 Miller Ave
Fort Worth, TX 76105-4164

Mailing address

PO Box 733784
Dallas, TX 75373-2429
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoayad168416@CookChildrens.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603001173 TX Practitioner - Pediatric Medicine 8022397421 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network Pediatrics CurrentSince Jun 30, 2021 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Jun 30, 2021 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Cook Children's Medical Center Past Accepting new patients

Locations

2755 Miller Ave
Fort Worth, TX 76105
Phone (817) 534-7110

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

Interoperability endpoints

  • Direct secure messaging: mmoayad168416@cookchildrens.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1982068722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732429",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 MILLER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761054164",
            "telephone_number": "817-534-7110",
            "fax_number": "817-413-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAYAD",
        "first_name": "MAY",
        "middle_name": "ANISA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T1467",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "312002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoayad168416@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "2755 Miller Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761054164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.