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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: October 18, 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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

6

Medicare enrollment records show Kenneth Moberg reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Project Renewal Inc
1.2 mi
Primary Care
8 EAST THIRD STREET
New York, NY 10003
  • Reassigned Medicare billing, New York enrollment
  • 25 clinicians in this Medicare group
NPI 1598770018 (212) 620-0340
Parcare Community Health Network Inc
3.6 mi
Multi-Specialty
445 PARK AVE
Brooklyn, NY 11205
  • Reassigned Medicare billing, New York enrollment
  • 193 clinicians in this Medicare group
NPI 1730454083 (718) 963-0800
Essen Medical Urgicare, PLLC
8.2 mi
Urgent Care
1550 UNIVERSITY AVE
Bronx, NY 10452
  • Reassigned Medicare billing, New York enrollment
  • 683 clinicians in this Medicare group
NPI 1841607298 (718) 583-7736
Essen Medical Associates, PC
9.0 mi
Legal Medicine
2015 GRAND CONCOURSE
Bronx, NY 10453
  • Reassigned Medicare billing, New York enrollment
  • 1,393 clinicians in this Medicare group
NPI 1366418709 (718) 583-7736
House Call Medical Services Of New York, PLLC
10 mi
Internal Medicine
1371 SEABURY AVE
Bronx, NY 10461
  • Reassigned Medicare billing, New York enrollment
  • 1,054 clinicians in this Medicare group
NPI 1851345946 (718) 294-6200
Bronx Medical Practice P.C.
11 mi
Internal Medicine
2626 HALPERIN AVE
Bronx, NY 10461
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Bronx Medical Practice PC
  • 1,013 clinicians in this Medicare group
NPI 1356726087 (646) 340-1309

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organizations bill Medicare for Kenneth Moberg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Moberg reassigns Medicare benefits to 6 organizations: Project Renewal Inc (New York, NY), Parcare Community Health Network Inc (Brooklyn, NY), Essen Medical Urgicare, PLLC (Bronx, NY), Essen Medical Associates, PC (Bronx, NY), House Call Medical Services Of New York, PLLC (Bronx, NY) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Moberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 13 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.