McKenna Elyse Moe, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10350 Issued in GA

Practice address

1955 Textile Way Ste B
Gainesville, GA 30501-2543

Phone

(678) 987-1499

Fax

(678) 987-1498

NPI assigned

Jul 21, 2021

Sex

Female

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 GA

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aga, LLCGroup PAC ID 2365431350, 138 clinicians

Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

Merit-based Incentive Payment System (MIPS)

Final score

74.39 of 100Reported as group

Quality

44.91

Promoting interoperability

98

Improvement activities

40

Cost

71.38

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mckenna.moe@ud.eclinicaldirectplus.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.

• Aga Professional Services, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1063799120
  Medicare reassignment Care Compare group
• Aga, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1124064118
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1124691712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 TEXTILE WAY STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012543",
            "telephone_number": "678-987-1499",
            "fax_number": "678-987-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 TEXTILE WAY STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012543",
            "telephone_number": "678-987-1499",
            "fax_number": "678-987-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "MCKENNA",
        "middle_name": "ELYSE",
        "name_prefix": "Miss",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anusha Mittal
• John Delano Mixon Sr., DDS
• Da Eun Mo, PHARM D
• Courtney Lee Modesitt, MS,OT
• Lori Angeleene Modly, CPNP
• Kellie Margaret Moffatt
• Sahir Mohammad, MD
• Sabira Mohammadi, PA
• Khaja Salahuddin Mohammed, MD
• Marylynn Mae Paulette Mohr, MS, LPC

• Physician Assistant in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.