Active NPI
Cletus Tanwi Moma, MD
- Internal Medicine Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- TRN16006
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Wayne State University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| TRN16006 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hni Medical Services of Florida, LLC | Internal Medicine | Current | Accepting new patients |
| Inpatient Consultants of Florida Inc | Internal Medicine | Current | Accepting new patients |
| Hamilton Physician Group Inc | Current | Accepting new patients | |
| Hospital Medicine Services of FL, LLC | Current | Accepting new patients | |
| Tift Regional Health System Inc | Current | Accepting new patients | |
| Georgia Hospitalists Group, LLC | Current | Accepting new patients | |
| Mayo Clinic Health System in Waycross, Inc. | Current | Accepting new patients | |
| Integrated Regional Laboratories Pathology Services, LLC | Current | Accepting new patients | |
| Hospital Physician Services of Florida PA | Internal Medicine | Current | Accepting new patients |
| Inpatient Consultants of Florida, Inc | Internal Medicine | Current | Accepting new patients |
| Cogent Healthcare of Jacksonville, LLC | Internal Medicine | Current | Accepting new patients |
| Sound Physicians of Florida IV, LLC | Internal Medicine | Current | Accepting new patients |
| Georgia Hospitalists Group, LLC | Current | Accepting new patients | |
| Cogent Healthcare of Jacksonville, LLC | Internal Medicine | Current | Accepting new patients |
| Mayo Clinic Health System in Waycross, Inc. | Current | Accepting new patients | |
| Hamilton Medical Center, Inc. | Current | Accepting new patients | |
| Sound Physicians of Florida IV, LLC | Internal Medicine | Current | 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
- 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.
-
- Hospitalist Physician
- Aventura, FL
- NPI 1710684857
-
- Hospitalist Physician
- Pensacola, FL
- NPI 1558718635
Internal Medicine
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1124252333
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1679048284
-
- Internal Medicine Physician
- Orange Park, FL
- NPI 1396795597
-
- Internal Medicine Physician
- Palm Coast, FL
- NPI 1740633635
-
- Hospitalist Physician
- Riverdale, GA
- NPI 1033576376
-
- General Acute Care Hospital
- Dalton, GA
- NPI 1528056066
-
- Multi-Specialty Clinic/Center
- Waycross, GA
- NPI 1154745982
-
- Internal Medicine Physician
- Port Orange, FL
- NPI 1861150625
-
- Hospitalist Physician
- Tampa, FL
- NPI 1457511164
Internal Medicine
-
- Anatomic Pathology & Clinical Pathology Physician
- Atlantis, FL
- NPI 1942526298
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Panama City, FL
- NPI 1699721589
-
- General Acute Care Hospital
- Crestview, FL
- NPI 1104897859
-
- General Acute Care Hospital
- Ft Walton Beach, FL
- NPI 1639128820
-
- General Acute Care Hospital
- Niceville, FL
- NPI 1891732988
-
- General Acute Care Hospital
- Palatka, FL
- NPI 1487045100
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.