Paul Moberg, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

171890-1 Issued in NY

Practice address

99 E State St
Gloversville, NY 12078-1203

Phone

(518) 773-5559

Fax

(518) 773-5601

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Nathan Littauer Hospital Association

  • Skilled Nursing Facility
  • Gloversville, NY
  • NPI 1073541850
  NPD (past)
• Warren Anesthesiologists Prof Corp

  • Anesthesiology Physician
  • Glens Falls, NY
  • NPI 1861583270
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1992720304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "address_2": "PO BOX 1250",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-773-5559",
            "fax_number": "518-773-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-773-5559",
            "fax_number": "518-773-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBERG",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "171890-1",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "171890",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01611123",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHPLAN",
            "identifier": "3006027",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10001397",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NORTHEASTERN NY",
            "identifier": "000406860004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Pauline Miller, RPH
• Shelly Ann Miller
• Melissa Elizabeth Mills, NCC
• Meghan Beth Miskinis, RN
• Deanna Mitzen
• Vincent Joseph Montagnino, RPA
• Thomas Moore Jr.
• Elyse Morales, RN
• Stanley Partridge Morgan Jr., RN
• Thomas Morgan, D.C.

• Anesthesiology Physician in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.