Individual provider Active NPI

Erin Elizabeth Moise, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1003584780
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14042 Issued in TX
Practice address
4910 Mueller Blvd
Suite 103
Austin, TX 78723
Phone
(512) 324-0040
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14042 TX Primary

Addresses

Primary practice location

4910 Mueller Blvd
Suite 103
Austin, TX 78723

Mailing address

4910 Mueller Blvd
Suite 103
Austin, TX 78723
Phone (512) 324-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220104001668 TX Practitioner - Physician Assistant 6204227101 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14042TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Sep 27, 2021 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4910 Mueller Blvd
Ste 103
Austin, TX 78723
Phone (512) 324-0040

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: erin.moise.1@8363.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1003584780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 MUELLER BLVD",
            "address_2": "SUITE 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78723",
            "telephone_number": "512-324-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 MUELLER BLVD",
            "address_2": "SUITE 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78723",
            "telephone_number": "512-324-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISE",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "14042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.