Individual provider Active NPI

Megan H Moffatt, PA

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1144572181
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106786 Issued in FL
Practice address
4193 Highwood Dr
Jacksonville, FL 32216-3618
Phone
(904) 502-9806
NPI assigned
Oct 15, 2012
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106786 FL
Medical Physician Assistant 363AM0700X PA9106786 FL Primary

Addresses

Primary practice location

4193 Highwood Dr
Jacksonville, FL 32216-3618

Mailing address

4193 Highwood Dr
Jacksonville, FL 32216-3618
Phone (904) 502-9806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20121029000269 FL Practitioner - Physician Assistant 5597915553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106786FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvita Wellness Center Current Accepting new patients
Emergency Physicians Inc CurrentSince Dec 15, 2021 Accepting new patients
Cep America LLC CurrentSince Jun 29, 2023 Accepting new patients
Cep America LLC CurrentSince Jun 29, 2023 Accepting new patients
Kite Emergency Physicians LLC Past Accepting new patients
Florida Em-I Medical Services, PA Physician Assistant Past Accepting new patients
Kingsley Avenue Emergency Physicians LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1144572181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4193 HIGHWOOD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163618",
            "telephone_number": "904-502-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4193 HIGHWOOD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163618",
            "telephone_number": "904-502-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "MEGAN",
        "middle_name": "H",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106786",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.