Individual provider Active NPI

Cletus Tanwi Moma, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1982998373
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TRN16006 Issued in FL
Practice address
4500 San Pablo Rd S
Provider Enrollment
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jun 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN16006 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Provider Enrollment
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Provider Enrollment
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140811002599 FL Practitioner - HospitalistPractitioner - Internal Medicine 0042446353 Reassigns benefits to 6 organizations
I20140923001479 GA Practitioner - Internal Medicine 0042446353 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians
Hospital Physician Services of Florida PAGroup PAC ID 7012201965, 212 clinicians

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach Medicla Center
Fort Walton Beach, FL 32547-6708
Phone (850) 864-0213

340 NW Commerce Dr
Lake City Medical Center
Lake City, FL 32055-4709
Phone (850) 719-9000

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (386) 328-5711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN16006FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Medical Services of Florida, LLC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Mar 27, 2020 Accepting new patients
Hamilton Physician Group Inc CurrentSince May 1, 2018 Accepting new patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Tift Regional Health System Inc CurrentSince Oct 1, 2017 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 25, 2016 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients
Hospital Physician Services of Florida PA Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Dec 27, 2016 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 25, 2016 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince May 1, 2018 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Dec 27, 2016 Accepting new patients

Locations (25 of 29)

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

12980 SW Highway 484
Dunnellon, FL 34432
Phone (352) 229-8465

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

1670 St Vincents Way
Middleburg, FL 32068
Phone (904) 308-3960

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

3100 E Fletcher Ave
#C
Tampa, FL 33613

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 5

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": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1982998373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMA",
        "first_name": "CLETUS",
        "middle_name": "TANWI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN16006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.