Individual provider Active NPI

Robert M Moylon, PA-C, ATC

  • Physician Assistant
  • Allen, TX
National Provider Identifier
1124161278
Registry record updated Feb 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08623 Issued in TX
Practice address
1218 W McDermott Dr
Allen, TX 75013-6304
Phone
(972) 390-9000
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 104-0000126 VT
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X PA08623 TX Primary

Addresses

Primary practice location

1218 W McDermott Dr
Allen, TX 75013-6304

Mailing address

PO Box 9101
Coppell, TX 75019-9494
Phone (972) 745-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130912000149 TX Practitioner - Physician Assistant 6406090570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4031 W Plano Pkwy
Suite 100
Plano, TX 75093-5617
Phone (972) 985-1072

5757 Warren Pkwy
Suite 180
Frisco, TX 75034-4548
Phone (972) 985-1072

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104-0000126VTMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Orthotexas Physicians and Surgeons, PLLC CurrentSince Jul 25, 2013 Accepting new patients
Doctx3 PLLC CurrentSince Feb 21, 2018 Accepting new patients
Doctx3 PLLC CurrentSince Feb 21, 2018 Accepting new patients
Primary Health Physicians, PLLC Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Prohealth Past Accepting new patients

Locations

709 E Slaughter Ln
Ste 404
Austin, TX 78744
Phone (512) 277-6643

3110 Guadalupe St
Ste 100
Austin, TX 78705
Phone (512) 599-9510

4780 N Josey Ln
Carrollton, TX 75010
Phone (972) 395-2293

9500 Dallas Pkwy
Ste 100
Frisco, TX 75033
Phone (469) 535-6647

3014 N O Connor Rd
Ste 200
Irving, TX 75062
Phone (214) 444-5558

4031 W Plano Pkwy
Ste 100
Plano, TX 75093
Phone (469) 326-8623

Interoperability endpoints

  • Direct secure messaging: robert.moylon.1@15749.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423353600000",
    "number": "1124161278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9101",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750199494",
            "telephone_number": "972-745-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W MCDERMOTT DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136304",
            "telephone_number": "972-390-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLON",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2015-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104-0000126",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.