Individual provider Active NPI

Michelle Elise Moreno, PA-C

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1013426683
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-3000
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

3934 28TH St Apt 3
Long Island City, NY 11101-3729
Phone (631) 235-6098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180219000375 NY Practitioner - Physician Assistant 1456612266 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

1 Miller PL
Smithtown, NY 11787-3629
Phone (631) 604-4024

19 W Jericho Tpke
Huntington Station, NY 11746-3627
Phone (631) 604-4022

1950 Jericho Tpke
East Northport, NY 11731-6207
Phone (631) 238-3065

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021473NYMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: michelle.moreno@ghuc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1013426683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3934 28TH ST APT 3",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013729",
            "telephone_number": "631-235-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MICHELLE",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.