Cesserie Samantha Moyer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9040 Jackson Ave
Joint Base Lewis McChord, WA 98431-9843

Phone

(253) 966-9818

NPI assigned

Nov 23, 2020

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1164026944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17511 75TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752536",
            "telephone_number": "913-217-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984319843",
            "telephone_number": "253-966-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "CESSERIE",
        "middle_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Moore, LMP
• Michael Benjamin Moore, DO
• Emani Georgette Morgan
• Ronald Richardson Morris, MD
• Douglas Ryan Morte, M.D.
• Daniel Luke Mudd, DVM
• Victor Kyle Mumford
• Jaysen J Muniz Sanchez, COTA/L
• Jessica Lynn Nelson, MD
• Jon Neumann, PT

• Physician Assistant in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.