Stephen Patrick Moon, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

MD17858 Issued in OR

Practice address

3838 Pacific Ave
Forest Grove, OR 97116-2224

Phone

(503) 992-0288

Fax

(503) 359-4742

NPI assigned

Dec 3, 2005

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 OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoon@santiam.securechart.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Medicare reassignment NPD
• Western Healthcare Services Texas

  • Emergency Medicine Physician
  • Gold Beach, OR
  • NPI 1336878024
  Medicare reassignment NPD
• Santiam Memorial Hospital

  dba Santiam General Surgery

  • Medical Specialty Clinic/Center
  • Stayton, OR
  • NPI 1396152351
  NPD
• Dallas Oregon Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dallas, OR
  • NPI 1659661155
  NPD (past)
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  NPD (past)
• San Francisco Physicians International Medical Group, Inc

  dba San Ramon Emergency Physicians

  • Emergency Medicine Physician
  • San Ramon, CA
  • NPI 1841220720
  NPD (past)

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

{
    "created_epoch": "1133568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1003890997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16788 SW SARALA ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970076572",
            "telephone_number": "503-380-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 PACIFIC AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162224",
            "telephone_number": "503-992-0288",
            "fax_number": "503-359-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-03",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OR",
            "license": "MD17858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valynn Mohorich
• Molly D. Saunders D.M.D. P.C.
• Britlee Monroe
• Yesenia Montanez Torres
• Moon Sisters Midwifery LLC
• Amanda Kay Moore, OTR/L
• Jobriath Michael Morgan, LCSW
• Sheila Dale Morrison, O.D.
• Movement Health and Sports Medicine
• Breanna Ashley Munsell, MSW, LCSW

• Emergency Medical Services (Emergency Medicine) Physician in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.