Shura A Moreno, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A78052 Issued in CA

Practice address

4146 E Olympic Blvd
Suite B
Los Angeles, CA 90023-3347

Phone

(323) 262-9943

Fax

(323) 262-3708

NPI assigned

Jul 18, 2006

Last updated

Oct 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Internal MedicineAlso: Family Practice

Education

University of California, Irvine, California College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Joseph Multi-Specialty Clinic CorpGroup PAC ID 6507295722, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hollycare Home Health, Inc Home health agency, El Monte, CA, CCN 757512
• Silver Age Home Care, Inc Home health agency, Granada Hills, CA, CCN 559119
• Celestial Care Hospice Hospice, North Hollywood, CA, CCN B31561

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• St Joseph Multi-Specialty Clinic Corp

  • Internal Medicine Physician
  • West Covina, CA
  • NPI 1487286316
  Medicare reassignment Care Compare group NPD Authorized official
• Gabriel Medical Center Inc

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1598129652
  Medicare reassignment NPD Authorized official
• Wellcare Valley Medical Group Inc

  • Internal Medicine Physician
  • Granada Hills, CA
  • NPI 1689473878
  Medicare reassignment NPD
• Shura a Moreno MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1417156860
  Authorized official Same address or phone
• Ahmc Monterey Park Hospital LP

  dba Monterey Park Hospital

  • General Acute Care Hospital
  • Monterey Park, CA
  • NPI 1780676221
  NPD (past)
• Alta Los Angeles Hospital, Inc

  dba Los Angeles Hospital

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1114132685
  NPD (past)
• Alta Los Angeles Hospitals, Inc.

  dba Los Angeles Comm Hosp, Norwalk Comm Hosp & LA Comm Hosp at Bellflower

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922001809
  NPD (past)
• Jason K Boutros M D Inc

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1053532580
  NPD (past)
• Jenny M Hwang Incorporated

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1992862791
  NPD (past)
• Jenny M. Hwang

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1255498820
  NPD (past)
• Pih Health Downey Hospital

  dba Downey Regional Medical Center

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1265433551
  NPD (past)
• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Celestial Care Hospice

  • Community Based Hospice Care Agency
  • North Hollywood, CA
  • NPI 1346866381
  Care Compare affiliation Name & address match
• Hollycare Home Health, Inc.

  • Home Health Agency
  • El Monte, CA
  • NPI 1952060337
  Care Compare affiliation
• Silver Age Home Care, Inc.

  • Home Health Agency
  • Granada Hills, CA
  • NPI 1821524414
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1174542716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4146 E OLYMPIC BLVD",
            "address_2": "SUITE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900233347",
            "telephone_number": "323-262-9948",
            "fax_number": "323-262-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4146 E OLYMPIC BLVD",
            "address_2": "SUITE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900233347",
            "telephone_number": "323-262-9943",
            "fax_number": "323-262-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "SHURA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A780520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "00A780520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Moreno
• Rosa C Moreno
• Rosa Maria Moreno
• Ryan Alyssa Moreno
• Samuel Moreno
• Silvia Moreno, RDA
• Sofia Moreno
• Stephanie Moreno
• Stephanie Moreno
• Stephanie Plancarte Moreno, BA. CLE,IFECTMHP

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.