Kyrra Moffatt, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A10604 Issued in CA

Practice address

8881 Fletcher Pkwy Ste 205
La Mesa, CA 91942-3187

Phone

(619) 464-6434

Fax

(619) 464-5109

NPI assigned

Jun 29, 2007

Last updated

Apr 15, 2025By the provider in NPPES

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Philip D Szold MD Inc

  dba La Mesa Pediatric Medical Group

  • Pediatrics Physician
  • La Mesa, CA
  • NPI 1427268747
  NPD (past) Authorized official
• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  NPD (past)
• Rady Children's Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1194922419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 205",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423187",
            "telephone_number": "619-464-6434",
            "fax_number": "619-464-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 205",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423187",
            "telephone_number": "619-464-6434",
            "fax_number": "619-464-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "KYRRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A10604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobile Neurology of San Diego
• Mobile Physician Services
• Darcy Fox Mock, M.D.
• Stella Moderau, PTA
• Laurie Modrow I
• Mansour Mofidi, DO
• Samira Osman Mohamed
• Ahmad Shah Mohammad, M.D.
• Mohammed G Al-Janabi, MD, Inc.
• Mohammed Miradi MD Inc

• Pediatrics Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.