Courtney G Moller, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

950 Campbell Ave
Gec240
West Haven, CT 06516-2770

Phone

(203) 932-5711

NPI assigned

Aug 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

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

University of Florida College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dana-Farber Cancer Institute, Inc.Group PAC ID 9133038904, 671 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Merit-based Incentive Payment System (MIPS)

Final score

84.06 of 100Reported as group

Quality

65.04

Promoting interoperability

100

Improvement activities

40

Cost

69.14

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: moller.courtney.dfci@direct.partners.masshiway.net

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.

• Dana-Farber Cancer Institute, Inc.

  • Special Hospital
  • Boston, MA
  • NPI 1346433257
  Medicare reassignment Care Compare group NPD
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment
• Dana-Farber Cancer Institute, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Chestnut Hill, MA
  • NPI 1497429237
  NPD
• Brigham and Womens Physicians Organization Inc

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1265464598
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1043467855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "GEC 240",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "GEC240",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLER",
        "first_name": "COURTNEY",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA3371",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002124",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jagoda Anna Misniakiewicz, PHARMD
• Jennifer Misuraca, ACNPC-AG
• Lorena Rivera Mitchell, LCSW
• Frances Vincent Mobilio, APRN
• Theresa A Molisse, M.D.
• Moma Premium Services LLC
• Jessica Monteiro, LMT, CMLDT
• Tekenya Monteiro, MSW
• Donna M Montesi, APRN
• Charra Monyae Moore

• Medical Physician Assistant in West Haven, CT
• Providers in West Haven, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.