Active NPI
Esmeralda Moreno, PA-C
- Physician Assistant
- Vega Alta, PR
National Provider Identifier
1245618396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1988
- Practice address
- HC 83 Box 6184
Vega Alta, PR 00692-9723 - Phone
- (704) 852-2403
- NPI assigned
- May 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1988 | PR | Primary |
Addresses
Primary practice location
HC 83 Box 6184
Vega Alta, PR 00692-9723
Mailing address
HC 83 Box 6184
Vega Alta, PR 00692-9723
Phone (704) 852-2403
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E69635585 | Other | VA | PCA CERTIFICATE |
| 1988 | Other | PR | PUERTO RICO GOVERMENT, DEPARTMENT OF HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1988 | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705276800000",
"number": "1245618396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 83 BOX 6184",
"city": "VEGA ALTA",
"state": "PR",
"postal_code": "006929723",
"telephone_number": "704-852-2403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 83 BOX 6184",
"city": "VEGA ALTA",
"state": "PR",
"postal_code": "006929723",
"telephone_number": "704-852-2403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "ESMERALDA",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-08",
"last_updated": "2024-01-15",
"certification_date": "2024-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "1988",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCA CERTIFICATE",
"identifier": "E69635585",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PUERTO RICO GOVERMENT, DEPARTMENT OF HEALTH",
"identifier": "1988",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vega Alta, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.