Moonah Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

MOONAH INC

Doing business as

Moonah Health

Practice address

82 Griswold Dr
West Hartford, CT 06119-3549

Phone

(302) 267-4679

NPI assigned

Dec 13, 2024

Organization subpart

No

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

Authorized official

Name

Luke A Kist

Title

Co -Founder

Phone

(251) 223-2212

Specialties & licenses 1

Addresses

Other names 1

• Moonah Health Doing business as

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1043027964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 GRISWOLD DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191146",
            "telephone_number": "251-223-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 GRISWOLD DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061193549",
            "telephone_number": "302-267-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONAH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "KIST",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO -FOUNDER",
        "authorized_official_telephone_number": "251-223-2212"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moonah Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Christine Mongillo, MA
• Marney Mongillo, OT
• Monica H. Cipes DMD PC
• Margaret Holland Monos
• Denise Anne Monte, M.S
• Marybeth Aucoin Moore, PA-C, MPH
• Pamela A Moore, DMD
• Colleen Moosman, P.T.A.
• Alyssa Rose Morabito, BA
• Kimberly A Morales, LCSW

• Exclusive Provider Organization in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Exclusive Provider Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.