Individual provider Active NPI

Meghan Emily Moore, PA

  • Physician Assistant
  • Santa Monica, CA
National Provider Identifier
1295778504
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19797 Issued in CA
Practice address
525 Broadway
Suite 1101
Santa Monica, CA 90401-2478
Phone
(310) 500-2045
Fax
(323) 305-7149
NPI assigned
Jun 14, 2006
Last updated
May 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 00346 RI
Physician Assistant 363A00000X 012972 NY
Physician Assistant 363A00000X PA19797 CA Primary

Addresses

Primary practice location

525 Broadway
Suite 1101
Santa Monica, CA 90401-2478

Mailing address

525 Broadway
Suite 1101
Santa Monica, CA 90401-2478
Phone (310) 500-2045

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908000653 CA Practitioner - Physician Assistant 9739191545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Seniors Group IncGroup PAC ID 1759769151, 53 clinicians

Practice addresses (Care Compare)

10000 Washington Blvd
Suite 108
Culver City, CA 90232-2782
Phone (888) 663-6331

525 Broadway
Suite 1101
Santa Monica, CA 90401-2971
Phone (310) 500-2045

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012972NYMDSpeech-Language Pathologist
PA19797CAMDPhysician Assistant
PA 00346RIMDPhysician Assistant
19797CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint John's Health Center Past Accepting new patients
Pathology Consultants of New London, P.C. Past Accepting new patients
One Medical Group, Inc. Past Accepting new patients
LMW Healthcare Inc. Physician Assistant Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1295778504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 BROADWAY",
            "address_2": "SUITE 1101",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012478",
            "telephone_number": "310-500-2045",
            "fax_number": "323-305-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BROADWAY",
            "address_2": "SUITE 1101",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012478",
            "telephone_number": "310-500-2045",
            "fax_number": "323-305-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MEGHAN",
        "middle_name": "EMILY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA 00346",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012972",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.