Andrew Moulton

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3333 Green Bay Rd
North Chicago, IL 60064-3037

Phone

(360) 930-2912

NPI assigned

May 6, 2020

Sex

Male

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 WA, ID2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

R Franklin University of Med & Sci/Chicago Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spokane Foot Clinic P SGroup PAC ID 3870481963, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.moulton.1@29206.direct.athenahealth.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.

• Spokane Foot Clinic, P S

  • Podiatric Clinic/Center
  • Spokane, WA
  • NPI 1215012331

  ID

  Medicare reassignment Care Compare group NPD
• Ironwood Drive Physical Therapy, PA

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1801812482
  NPD
• Spokane Foot Clinic, P S

  • Podiatric Clinic/Center
  • Spokane, WA
  • NPI 1982789095
  NPD
• Spokane Foot Clinic, P S

  • Podiatric Clinic/Center
  • Spokane, WA
  • NPI 1306921424
  NPD (past)

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1164043626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037",
            "telephone_number": "360-930-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Morin, PH.D.
• Demetrios George Morris, DDS
• Jeanette Levine Morrison, MD
• Rianne Renee Morrison, M.S. CCC-SLP
• Rodney Lee Morrow, DDS
• Madelyn Moulton
• Dillon Moyer, PHARMD
• Morgan Mroz
• Jessica Louise Muehr, DPT
• Peter T Mui, PHARM.D.

• Student in an Organized Health Care Education/Training Program in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.