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JOSEPH S MOAK JR MD PA
NPI 1043639289
Internal Medicine in Brookhaven, MS

Active since April 15, 2014
1040 BIGLANE DRIVE, BROOKHAVEN, MS 39601(601) 833-5051(601) 835-0240 Get Directions Write a Review

NPPES record last updated: May 30, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Joseph S Moak Jr Md Pa NPPES

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

JOSEPH S MOAK JR MD PA (NPI 1043639289) is a healthcare organization registered as an internal medicine in Brookhaven, Mississippi and active in the NPI registry since April 2014. The organization lists Antha R. Restivo, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1043639289
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJOSEPH S MOAK JR MD PA
Location Address1040 BIGLANE DRIVEBrookhaven, MS 39601
Mailing Address1040 Biglane DriveBrookhaven, MS 39601 · (601) 833-5051 · Fax (601) 835-0240
Phone(601) 833-5051
Fax(601) 835-0240
Organization SubpartNo
Authorized OfficialAntha R. RestivoOffice Manager · (601) 833-5051
Enumeration DateApril 15, 2014
Last NPPES UpdateMay 30, 2014
✔ NPI 1043639289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1040 BIGLANE DRIVE, Brookhaven, MS 39601
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joseph S Moak Jr Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMississippiEnrollment IDO20140728001142Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Joseph S Moak Jr MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Joseph Moak, MD
Internal Medicine
NPI 1184667800
2500 NORTH STATE STREET DEPARTMENT OF MEDICINE DIV GENERAL INTERNAL MEDICINE
Jackson, MS 39216
(601) 984-5660
✔ PECOS✔ Accepts Medicare54 mi

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

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 Joseph S Moak Jr MD PA's NPI number?

The NPI number for Joseph S Moak Jr MD PA is 1043639289. It was assigned to this organization in the NPPES registry on April 15, 2014.

Where is Joseph S Moak Jr MD PA located?

Joseph S Moak Jr MD PA is located at 1040 Biglane Drive, Brookhaven, MS 39601. The listed phone number is (601) 833-5051.

What is Joseph S Moak Jr MD PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Joseph S Moak Jr MD PA enrolled in Medicare?

Yes. Joseph S Moak Jr MD PA is registered in the Medicare PECOS enrollment system.

When is Joseph S Moak Jr MD PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Joseph S Moak Jr MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Joseph S Moak Jr MD PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Joseph S Moak Jr MD PA was last updated on May 30, 2014. 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.