Jessica Mae Moody, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3474 Issued in AZ

Practice address

11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039

Phone

(480) 900-3556

NPI assigned

Mar 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Doctor on Call Corp

  • General Practice Physician
  • Phoenix, AZ
  • NPI 1194420174
  Medicare reassignment Authorized official
• Laser Spine Institute of Arizona, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1174778484
  NPD (past)
• Laser Spine Institute, LLC

  • Specialist
  • Tampa, FL
  • NPI 1265483895
  NPD (past)

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1043349400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28727 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850850727",
            "telephone_number": "520-780-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 N TATUM BLVD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286039",
            "telephone_number": "480-900-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3474",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Mony, LCSW
• Andrew James Monzon, BCBA, LBA
• Moodclinics LLC
• Aijshia N Moody
• Ashley Moody
• Sierra Morgan Moody
• Vanessa Moody
• Kalyani S Moola, M.D.
• Moon Valley Anesthesiologists, LTD
• Moon Valley Dental LLC

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.