Patrick Sean Moltmaker, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11002615 Issued in FL

Practice address

611 E Adams St
Jacksonville, FL 32202-2847

Phone

(904) 394-1356

NPI assigned

Jun 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patrick.moltmaker.1@21075.direct.athenahealth.com

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.

• Im Sulzbacher Center for the Homeless, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1710051354
  Medicare reassignment NPD
• Im Sulzbacher Center for the Homeless, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1396369187
  NPD

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1104484096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 FORD WOOD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188422",
            "telephone_number": "904-508-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-394-1356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "934 Ford Wood Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322188422",
            "country_code": "US",
            "telephone_number": "904-508-8768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11820 Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322466670",
            "country_code": "US",
            "telephone_number": "904-642-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLTMAKER",
        "first_name": "PATRICK",
        "middle_name": "SEAN",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11002615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Sophia Mollinedo
• Erin E. Mollitt, PA-C
• Sean Molloy, DNP
• Samantha Molock
• George Molson, CRNA
• Casey Lee Molumby, ARNP
• Kayla A. Molzof
• Cletus Tanwi Moma, MD
• Noela J Momburi
• Janae Moment, MD

• Psychiatric/Mental Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.