Jesse Alvin Moses, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7852060-1206 Issued in UT

Practice address

1478 East Highway 162
Montezuma Creek, UT 84534-0130

Phone

(435) 651-3700

Fax

(435) 678-0608

NPI assigned

Sep 16, 2014

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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 UT

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Navajo Health System IncorporatedGroup PAC ID 1658275649, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16098/brand/1/csg/1/fhir/r4
• Direct secure messaging: jesse.moses.1@16098.direct.athenahealth.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.

• Utah Navajo Health System, Incorporated

  dba Montezuma Creek Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Montezuma Creek, UT
  • NPI 1811991151
  Medicare reassignment Care Compare group NPD
• Utah Navajo Health System, Incorporated

  dba Blanding Family Practice Community Health Center

  • Family Medicine Physician
  • Blanding, UT
  • NPI 1457489486
  NPD (past)

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1033511563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "telephone_number": "435-651-3700",
            "fax_number": "435-651-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 EAST HIGHWAY 162",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "telephone_number": "435-651-3700",
            "fax_number": "435-678-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "JESSE",
        "middle_name": "ALVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2022-03-10",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7852060-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roselyn Maryboy, LCSW
• Casey Kent McCullough, M.D.
• Lindsey Rae McGarry, PHD
• Eugene L Meyer, RPH
• Chad Taylor Moses, PHARM. D
• Joshua Hinckley Nielson, DO
• Brian F Olsen, D.D.S
• Nicolette Joy Olsen, CMHC
• Cheyna Shumway Palmer, R.D.
• Deirdre M Piotrowski, MSW

• Physician Assistant in Montezuma Creek, UT
• Providers in Montezuma Creek, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.