NPIMap

Individual provider Active NPI

Kyaw Moe, MD

  • Nephrology Physician
  • Lakewood, CA
National Provider Identifier
1083649735
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A109324 Issued in CA
Practice address
3650 South St
Suite 101
Lakewood, CA 90712-1502
Phone
(562) 286-6466
Fax
(562) 286-6465
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD429546 PA
Nephrology Physician 207RN0300X A109324 CA Primary

Addresses

Primary practice location

3650 South St
Suite 101
Lakewood, CA 90712-1502

Mailing address

3650 South St
Suite 101
Lakewood, CA 90712-1502
Phone (562) 286-6466

Other identifiers 2

IdentifierTypeStateIssuer
101707491MedicaidPA
232359401OtherPAMAIN LINE HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100128000779 CA Practitioner - NephrologyPractitioner - Internal Medicine 5193721876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10861 Cherry St
Los Alamitos, CA 90720-5403

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 728-5034

3851 Katella Ave
Suite 325
Los Alamitos, CA 90720-3574
Phone (562) 286-6466

5750 Downey Ave
Suite 100
Lakewood, CA 90712-1411
Phone (562) 630-3105

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
49.93 of 100Reported as individual
Quality
33.33
Promoting interoperability
22
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
109324CAMDMarriage & Family Therapist
MD429546PAMDInternal Medicine Physician
A109324CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group, Inc. Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
Prohealth Partners, a Medical Group Internal Medicine Current Accepting new patients
Kyaw Moe MD a Professional Corporation Nephrology CurrentSince Sep 2, 2012 Accepting new patients
Prohealth Partners a Medical Group CurrentSince Mar 1, 2018 Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
University of California Irvine Past Accepting new patients
Southland Renal Medical Group, Inc. Nephrology Past Accepting new patients
Southland Renal Medical Group, Inc. Nephrology Past Accepting new patients

Locations

12131 Carson St
Hawaiian Gardens, CA 90716
Phone (562) 809-0299

17822 Beach Blvd
Ste 373
Huntington Beach, CA 92647
Phone (714) 848-3333

5750 Downey Ave
Ste 100
Lakewood, CA 90712
Phone (562) 630-3105

3650 South St
Ste 101
Lakewood, CA 90712
Phone (562) 286-6466

3650 South St
Ste 408
Lakewood, CA 90712
Phone (562) 630-0423

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

10861 Cherry St
Ste 104
Los Alamitos, CA 90720
Phone (562) 431-8771

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

3851 Katella Ave
Ste 325
Los Alamitos, CA 90720
Phone (562) 286-6466

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1083649735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST",
            "address_2": "SUITE 101",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121502",
            "telephone_number": "562-286-6466",
            "fax_number": "562-286-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST",
            "address_2": "SUITE 101",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121502",
            "telephone_number": "562-286-6466",
            "fax_number": "562-286-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "KYAW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD429546",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A109324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101707491",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN LINE HEALTHCARE",
            "identifier": "232359401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.