Renee Moreno, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A192622 Issued in CA

Practice address

79430 Highway 111 Ste 102
La Quinta, CA 92253-4549

Phone

(951) 827-7793

Fax

(760) 400-9971

NPI assigned

Mar 23, 2021

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

Other names 1

• Dr. Renee Moreno Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Regents of the University of California

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1811255060
  Medicare reassignment NPD
• Ucr Health - Psychiatry

  • Psychiatry Physician
  • Irvine, CA
  • NPI 1336679109
  NPD
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1043896574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79430 HIGHWAY 111 STE 102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534549",
            "telephone_number": "951-827-7793",
            "fax_number": "760-400-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79430 HIGHWAY 111 STE 102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534549",
            "telephone_number": "951-827-7793",
            "fax_number": "760-400-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A192622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "MORENO",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mohammad Yousef Alkhatib MD Inc
• Lizzet Monroy
• Nancy Montigny, RN
• Marcellus H. Moore, M.D.
• Rachael Moreno
• Natalia Morris, PA-C
• Mowrey Dental Corporation
• Alexis B Mox
• Stefanie Moye
• Hannah Marie Mirasol Muniz Castro, MD

• Pediatrics Physician in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.