Edgar Moreno, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

57434 Issued in CA

Practice address

3008 Sillect Ave Ste 220
Bakersfield, CA 93308-6362

Phone

(661) 748-1999

Fax

(661) 748-1815

NPI assigned

Oct 10, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGEGCA/Endpoint/GGEGCA

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.

• Centric Health

  • Cardiovascular Disease Physician
  • Bakersfield, CA
  • NPI 1831248236
  Medicare reassignment NPD (past)
• Bakersfield Memorial Hospital

  • Institutional Pharmacy
  • Bakersfield, CA
  • NPI 1144256363
  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1003381583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1139",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021139",
            "telephone_number": "661-371-2796",
            "fax_number": "661-438-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 SILLECT AVE STE 220",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086362",
            "telephone_number": "661-748-1999",
            "fax_number": "661-748-1815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11612 Bolthouse Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933118497",
            "country_code": "US",
            "telephone_number": "661-748-1999",
            "fax_number": "661-748-1815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "EDGAR",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianda Moreno
• Brooke Cara Moreno
• Courtney Moreno, FNP
• Cristina Moreno, MFTI
• Dyondra Nava Moreno
• Elana Melissa Moreno
• Fatima Jasiel Moreno
• Gavriela Moreno
• Genesis Moreno
• Gladys Edith Moreno, FNP-C

• Physician Assistant in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.