Active NPI
Lisa Michelle Gitthens Moses, RRT
- Pulmonary Disease Physician
- Manteca, CA
National Provider Identifier
1114498789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 29502
- Practice address
- 1721 W Yosemite Ave
Manteca, CA 95337-5130 - Phone
- (209) 824-5086
- NPI assigned
- Dec 7, 2018
- Last updated
- Jan 3, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 29502 | CA | Primary |
Addresses
Primary practice location
1721 W Yosemite Ave
Manteca, CA 95337-5130
Mailing address
836 Sunrise Ave
Ripon, CA 95366-2049
Phone (209) 531-5602
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29502 | CA | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1114498789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 SUNRISE AVE",
"city": "RIPON",
"state": "CA",
"postal_code": "953662049",
"telephone_number": "209-531-5602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 W YOSEMITE AVE",
"city": "MANTECA",
"state": "CA",
"postal_code": "953375130",
"telephone_number": "209-824-5086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GITTHENS MOSES",
"first_name": "LISA",
"middle_name": "MICHELLE",
"credential": "RRT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-07",
"last_updated": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "29502",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4601 Dale Rd",
"city": "Modesto",
"state": "CA",
"country_code": "US",
"postal_code": "953569718",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.