Katie Lynn Pernot-Moyer, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP028097 Issued in PA

Practice address

1371 N Washington Ave
Scranton, PA 18509-2840

Phone

(570) 963-6639

NPI assigned

Oct 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ophelia Medical Group FL, P.a.

  • Addiction Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1588244750
  Medicare reassignment Care Compare group NPD
• Encore Clinical Services - PA LLC

  • Nurse Practitioner
  • Bristol, PA
  • NPI 1992487540
  Medicare reassignment NPD
• Rural Health Corporation of Northeastern Pennsylvania

  • Federally Qualified Health Center (FQHC)
  • Wilkes Barre, PA
  • NPI 1265801112
  Medicare reassignment NPD
• Ophelia Medical Group, P.C.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Philadelphia, PA
  • NPI 1376179150
  NPD
• Rural Health Corporation of Northeastern Pennsylvania

  • Federally Qualified Health Center (FQHC)
  • Wilkes-Barre, PA
  • NPI 1437351640
  NPD
• Rural Health Corporation of Northeastern Pennsylvania

  • Federally Qualified Health Center (FQHC)
  • Hazleton, PA
  • NPI 1679115760
  NPD
• Rural Health Corporation of Northeastern Pennsylvania

  • Federally Qualified Health Center (FQHC)
  • Falls, PA
  • NPI 1205938578
  NPD (past)

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1114707882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 CENTER ST",
            "city": "DUPONT",
            "state": "PA",
            "postal_code": "186411430",
            "telephone_number": "570-479-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 N WASHINGTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185092840",
            "telephone_number": "570-963-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Cecil B Moore Ave Apt 204",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191223243",
            "country_code": "US",
            "telephone_number": "866-306-2026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERNOT-MOYER",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP028097",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP028097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Andre Pepen
• Tara Ann Peregrim, M.S. CCC-SLP
• Desirae Perez
• Carol Ann C Perfilio Pamelia, DC
• Joyce A Perih, DDS, MS
• Marisa Perrella, PHARMD
• Courtnie Paige Perri, MS, NCC
• P. Joseph Perrotti, DMD
• Anthony Michael Perry, M.D.
• Jamilyn Marie Perry, D.P.T., P.T.

• Gerontology Nurse Practitioner in Scranton, PA
• Providers in Scranton, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.