Active NPI
Cathy Moon
- Optometrist
- Philadelphia, PA
National Provider Identifier
1043788946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG003505
- Practice address
- 1523 Walnut St
Philadelphia, PA 19102-3001 - Phone
- (215) 845-0987
- NPI assigned
- Nov 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV008900-1 | NY | |
| Optometrist | 152W00000X | OEG003505 | PA | Primary |
Addresses
Primary practice location
1523 Walnut St
Philadelphia, PA 19102-3001
Mailing address
1523 Walnut St
Philadelphia, PA 19102-3001
Phone (215) 845-0987
Other practice location 1
1258 6th Ave
New York, NY 10020-1511
Phone (646) 789-4843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV008900-1 | NY | MD | Optometrist |
| OEG003505 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warby Parker Inc. | Past | Accepting new patients | |
| Warby Parker Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Eyewear Supplier
- Philadelphia, PA
- NPI 1679090765
-
- Eyewear Supplier
- New York, NY
- NPI 1538671573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577145600000",
"number": "1043788946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1523 WALNUT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023001",
"telephone_number": "215-845-0987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1523 WALNUT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023001",
"telephone_number": "215-845-0987"
}
],
"practiceLocations": [
{
"address_1": "1258 6th Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100201511",
"country_code": "US",
"telephone_number": "646-789-4843",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOON",
"first_name": "CATHY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-08",
"last_updated": "2019-12-24",
"certification_date": "2019-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV008900-1",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG003505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.