NPIMap

Individual provider Active NPI

Mollie Moore, PA-C, MSPAS, MPH

  • Medical Physician Assistant
  • Novato, CA
National Provider Identifier
1144669938
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA23010 Issued in CA
Practice address
5800 Nave Dr Ste F
Novato, CA 94949-6403
Phone
(415) 483-4807
NPI assigned
Jun 14, 2013
Last updated
Jan 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA23010 CA Primary

Addresses

Primary practice location

5800 Nave Dr Ste F
Novato, CA 94949-6403

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Other names 1

  • Mollie Ann Schneider Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140721001334 CA Practitioner - Physician Assistant 1254557655 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA23010CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Huntington Medical Foundation CurrentSince Feb 1, 2015 Accepting new patients
Sequoia Health Services Past Accepting new patients
Marin General Hospital Past Accepting new patients
Carbon Health Primary Care of California PC PastSince Feb 25, 2021 Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

65 N Madison Ave
Ste 800
Pasadena, CA 91101
Phone (626) 792-3141

Interoperability endpoints

  • Direct secure messaging: mmoore294017@direct-ucsfmedicalcenter.org
  • Direct secure messaging: mschneider209591@hisp.ehr.sutterhealth.org

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1144669938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 NAVE DR STE F",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496403",
            "telephone_number": "415-483-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MOLLIE",
        "credential": "PA-C, MSPAS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA23010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLIE",
            "last_name": "SCHNEIDER",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.