Individual provider Active NPI

Moises Dimas, PA

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1093422768
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12968 Issued in NC
Practice address
5107 College Center Dr
Fayetteville, NC 28311-1463
Phone
(336) 970-3943
NPI assigned
Nov 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-12968 NC Primary

Addresses

Primary practice location

5107 College Center Dr
Fayetteville, NC 28311-1463

Mailing address

5107 College Center Dr
Fayetteville, NC 28311-1463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20230223001223 NC Practitioner - Physician Assistant 5294108189 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as group
Quality
84.49
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.5 of 100Reported as group
Quality
84.11
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
82.48
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mdimas1104372@direct.novanthealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1093422768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 COLLEGE CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 COLLEGE CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111463",
            "telephone_number": "336-970-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMAS",
        "first_name": "MOISES",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.