Individual provider Active NPI

Moises Alfonso Moreno, D.O.

  • Emergency Medicine Physician
  • Miami, FL
National Provider Identifier
1992054639
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13252 Issued in FL
Practice address
11750 SW 40TH St
Miami, FL 33175
Phone
(305) 227-5544
NPI assigned
Sep 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13252 FL Primary

Addresses

Primary practice location

11750 SW 40TH St
Miami, FL 33175

Mailing address

11750 SW 40TH St
Miami, FL 33175-3530
Phone (305) 227-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190124002327 FL Practitioner - Emergency Medicine 8729376744 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13252FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Emergency Physician Solutions of South Florida, LLC Emergency Medicine PastSince Mar 1, 2020 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

10915 NW 41st St
Doral, FL 33178
Phone (305) 227-5548

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

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

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

Interoperability endpoints

  • Direct secure messaging: moises.moreno.1@14931.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1992054639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "305-227-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33175",
            "telephone_number": "305-227-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MOISES",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-07",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "13252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.