Dr Jeremy Ethan Moss, MD, PHD is a medicare enrolled "Dermatology" physician in Madison, Connecticut. He went to New York University School Of Medicine and graduated in 2001 and has 24 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Integrated Dermatology Of Clinton Llc, Integrated Dermatology Of Waterbury Llc and his current practice location is
1343 Boston Post Rd Apt 101, Madison, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 259-4037.
Dr Jeremy Ethan Moss is licensed to practice in Connecticut (license number 043137) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1689625188.
Physician's Profile
| Full Name | Dr Jeremy Ethan Moss |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 24 Years |
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| Location | 1343 Boston Post Rd Apt 101, Madison, Connecticut |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Jeremy Ethan Moss attended and graduated from New York University School Of Medicine in 2001
NPI Data:
- NPI Number: 1689625188
- Provider Enumeration Date: 05/12/2006
- Last Update Date: 09/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 8123057205
- Enrollment ID: I20050809000663
Medical Identifiers
Medical identifiers for Dr Jeremy Ethan Moss such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1689625188 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207N00000X | Dermatology | 043137 (Connecticut) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Integrated Dermatology Of Clinton Llc | 7416257381 | 7 |
| Integrated Dermatology Of Waterbury Llc | 9133467665 | 5 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jeremy Ethan Moss allows following entities to bill medicare on his behalf.
| Entity Name | Integrated Dermatology Of Clinton Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457728883 PECOS PAC ID: 7416257381 Enrollment ID: O20151125000408 |
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| Entity Name | Integrated Dermatology Of Waterbury Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588136220 PECOS PAC ID: 9133467665 Enrollment ID: O20190208000034 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jeremy Ethan Moss is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Jeremy Ethan Moss, MD, PHD 1343 Boston Post Rd Apt 101, Madison, CT 06443-3481 Ph: (860) 259-4037 | Dr Jeremy Ethan Moss, MD, PHD 1343 Boston Post Rd Apt 101, Madison, CT 06443-3481 Ph: (860) 259-4037 |
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