Amanda Theresa Moon, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD013064E Issued in PA

Practice address

219 N Broad St
4TH Floor
Philadelphia, PA 19107-1519

Phone

(215) 762-5550

NPI assigned

Jun 14, 2010

Last updated

Sep 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Amanda Theresa Carolfi Former name

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment NPD
• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Childrens Health Care Associates of New Jersey PC

  dba Chca NJ

  • Pediatrics Physician
  • Voorhees, NJ
  • NPI 1427152917
  Medicare reassignment NPD
• Childen's Health Care Associates Inc.

  dba CHCA Nurse Practitioners

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD
• Children's Health Care Associates

  dba CHCA Metabolism

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1083709042
  NPD
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel ID Partnership Clinic

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1538279732
  NPD
• Childens Health Care Associates of New Jersey PC

  dba CHCA NJ Emergency Medicine

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Voorhees, NJ
  • NPI 1467547471
  NPD
• Childrens Health Care Associates of New Jersey PC

  dba CHCA NJ Development Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Voorhees, NJ
  • NPI 1558456566
  NPD

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1144541186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021320",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "address_2": "4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "AMANDA",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD013064E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CAROLFI",
            "middle_name": "THERESA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meagan J Moody, MSW
• Nikia Moody, PHARM. D
• Sabrina Moody
• Bijoyesh Mookerjee, M.D.
• David Moolten, MD
• Bo Hyun Moon, MD, MBA
• Cathy Moon
• Christina Soyoung Moon, M.D.
• Daeuk Moon
• Edmund K Moon, MD

• Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.