Individual provider Active NPI

Aye Chan Moe

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1255105805
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
350 Hawthorne Ave
Oakland, CA 94609-3108
Phone
(510) 869-1562
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

350 Hawthorne Ave
Oakland, CA 94609-3108

Mailing address

925 Seneca St
Seattle, WA 98101-2742

Other practice location 1

4610 X St
Sacramento, CA 95817-2200
Phone (916) 734-4800

Other practice location 2

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20260625005006 WA Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 4688147010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1255105805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SENECA ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093108",
            "telephone_number": "510-869-1562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 X St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172200",
            "country_code": "US",
            "telephone_number": "916-734-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 Seneca St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012742",
            "country_code": "US",
            "telephone_number": "206-223-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOE",
        "first_name": "AYE CHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.