Dustin Joel Moon, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305216399 Issued in VA

Practice address

111 Monticello Ave Ste B
Charlottesville, VA 22902-5698

Phone

(434) 817-7848

NPI assigned

Sep 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy at AcacGroup PAC ID 7214907211, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy at Acac

  • Physical Therapist
  • Charlottesville, VA
  • NPI 1205809506
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment NPD
• Physical Therapy at Acac

  • Occupational Therapist
  • Charlottesville, VA
  • NPI 1497474977
  NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD
• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Pacific City, OR
  • NPI 1194231159
  NPD
• H & P Goodell, Inc.

  • Physical Therapy Clinic/Center
  • Portland, OR
  • NPI 1013908169
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1174774822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 ALBEMARLE SQ",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229017405",
            "telephone_number": "434-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MONTICELLO AVE STE B",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025698",
            "telephone_number": "434-817-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 NE 2nd Street",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977568249",
            "country_code": "US",
            "telephone_number": "541-504-2350",
            "fax_number": "541-923-7550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "DUSTIN",
        "middle_name": "JOEL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5786",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500601383",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Montoya, DNP FNP
• David Tipton Moody, M.D.
• Addison Moon
• Ashley Virginia Moon, MD
• Dayoung Moon, PA-C
• Rachel Y. Moon, M.D.
• Brian Mooney, DDS
• Amanda Moore
• Christopher Moore, M.D.
• Christopher M. Moore, M.D.

• Physical Therapist in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.