Active NPI
Caroline Martin Moreno, PA-C
- Physician Assistant
- Amelia, OH
National Provider Identifier
1053988097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.006992
- Practice address
- 3851 Golden Meadow CT
Amelia, OH 45102-2635 - Phone
- (513) 328-1527
- NPI assigned
- Jun 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.006992 | OH | Primary |
Addresses
Primary practice location
3851 Golden Meadow CT
Amelia, OH 45102-2635
Mailing address
3851 Golden Meadow CT
Amelia, OH 45102-2635
Phone (513) 328-1527
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.006992 | OH | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1053988097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3851 GOLDEN MEADOW CT",
"city": "AMELIA",
"state": "OH",
"postal_code": "451022635",
"telephone_number": "513-328-1527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3851 GOLDEN MEADOW CT",
"city": "AMELIA",
"state": "OH",
"postal_code": "451022635",
"telephone_number": "513-328-1527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "CAROLINE",
"middle_name": "MARTIN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.006992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amelia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.