Individual provider Active NPI

Kaitlyn Moorhouse, AGACNP-BC

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1366191306
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1060446 Issued in TX
Practice address
4411 Medical Dr Ste 120
San Antonio, TX 78229-3832
Phone
(210) 614-5400
NPI assigned
Mar 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1060446 TX
Nurse Practitioner 363L00000X 1060446 TX Primary

Addresses

Primary practice location

4411 Medical Dr Ste 120
San Antonio, TX 78229-3832

Mailing address

103 Suffolk PL
San Antonio, TX 78201-3142
Phone (432) 223-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220421000496 TX Practitioner - Nurse Practitioner 7416344403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Clinic of San Antonio, PLLCGroup PAC ID 1153517420, 125 clinicians

Practice addresses (Care Compare)

4458 Medical Dr
Suite 640
San Antonio, TX 78229-3739
Phone (210) 614-5400

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as group
Quality
75.23
Promoting interoperability
99
Improvement activities
40
Cost
76.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1060446TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Clinic of San Antonio, PLLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

4458 Medical Dr
Ste 640
San Antonio, TX 78229
Phone (702) 659-5604

4411 Medical Dr
Ste 120
San Antonio, TX 78229

4411 Medical Dr
Ste 300
San Antonio, TX 78229
Phone (210) 582-5145

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1366191306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SUFFOLK PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782013142",
            "telephone_number": "432-223-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293832",
            "telephone_number": "210-614-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORHOUSE",
        "first_name": "KAITLYN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1060446",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1060446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.