Jennifer Diane Moe, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00049401 Issued in WA

Practice address

1550 N 115TH St
Northwest Hospital Emergency Department, a-150
Seattle, WA 98133-8401

Phone

(206) 364-0500

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417305600000",
    "number": "1205043098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11139 CHAMPAGNE POINT RD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343409",
            "telephone_number": "425-954-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N 115TH ST",
            "address_2": "NORTHWEST HOSPITAL EMERGENCY DEPARTMENT, A-150",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338401",
            "telephone_number": "206-364-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "R-7626",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "37696",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00049401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir Modarressi, MD
• Modern Dermatology, PLLC
• Purvi Mody
• Michael David Modzelewski, MD
• Ashlee Kay Moe, BT
• Kristen Sean Moe
• Kimberlynn Moeai
• Jillian Moehle, ND
• Gloria Moeller, CRNA
• Olivia Moeller, MD

• Emergency Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2014; 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.