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MR. KENNETH ALLEN MOBERG NURSE PRACTITIONER
NPI 1033379540
Nurse Practitioner - Adult Health in New York, NY

Active since June 10, 2008PECOS Enrolled
121B WEST 20TH STREET, VILLAGE DIAGNOSTIC & TREATMENT CENTER, NEW YORK, NY 10011(212) 337-9290(212) 337-9275 Get Directions Write a Review

NPPES record last updated: August 27, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Kenneth Allen Moberg Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENNETH ALLEN MOBERG NURSE PRACTITIONER (NPI 1033379540) is an individual adult health provider in New York, New York, licensed in New York (F302611-1) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033379540
Entity TypeIndividualMale
Primary Taxonomy363LA2200X
Provider Legal NameMR. KENNETH ALLEN MOBERGCredential: NURSE PRACTITIONER
Location Address121B WEST 20TH STREET, VILLAGE DIAGNOSTIC & TREATMENT CENTERNew York, NY 10011
Mailing Address121b West 20th Street, Village Diagnostic & Treatment CenterNew York, NY 10011 · (212) 337-9290 · Fax (212) 337-9275
Phone(212) 337-9290
Fax(212) 337-9275
Sole ProprietorYes
Enumeration DateJune 10, 2008
Last NPPES UpdateAugust 27, 2013
✔ NPI 1033379540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · F302611-1
121B WEST 20TH STREET, New York, NY 10011
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Other Identifiers 1

Medicaid03084613NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kenneth Allen Moberg Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Moberg's NPI number?

The NPI number for Kenneth Moberg is 1033379540. It was assigned to this individual provider in the NPPES registry on June 10, 2008.

Where is Kenneth Moberg located?

Kenneth Moberg practices at 121B West 20th Street Village Diagnostic & Treatment Center, New York, NY 10011. The listed phone number is (212) 337-9290.

What is Kenneth Moberg's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Kenneth Moberg enrolled in Medicare?

Yes. Kenneth Moberg is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Moberg was last updated on August 27, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.