Individual provider Active NPI

Ava Kelley Moran, OD

  • Optometrist
  • Newburyport, MA
National Provider Identifier
1346080470
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT5735 Issued in MA
Practice address
39 Green St
Newburyport, MA 01950-2652
Phone
(978) 465-8761
NPI assigned
May 28, 2024
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT5735 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

39 Green St
Newburyport, MA 01950-2652

Mailing address

149 Orchard St
Byfield, MA 01922-1606
Phone (978) 778-5499

Other practice location 1

1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone (215) 276-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001003025 MA Practitioner - Optometry 0143751123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appleton Eye Associates PCGroup PAC ID 0840367975, 9 clinicians

Practice addresses (Care Compare)

39 Green St
Newburyport, MA 01950-2652
Phone (978) 465-8761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT5735MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Appleton Eye Associates PC Optometrist Current Accepting new patients
Appleton Eye Associates P.C. Optometrist CurrentSince Sep 3, 2024 Accepting new patients
Appleton Eye Associates PC Optometrist CurrentSince Sep 3, 2024 Accepting new patients

Locations

77 Main St
Amesbury, MA 01913
Phone (978) 388-1060

39 Green St
Newburyport, MA 01950
Phone (978) 465-8761

Organizations & group practices 3

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": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1346080470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 ORCHARD ST",
            "city": "BYFIELD",
            "state": "MA",
            "postal_code": "019221606",
            "telephone_number": "978-778-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 GREEN ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502652",
            "telephone_number": "978-465-8761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Godfrey Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413323",
            "country_code": "US",
            "telephone_number": "215-276-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "AVA",
        "middle_name": "KELLEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT5735",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.