Active NPI
Moira Kehoe, NP
- Women's Health Nurse Practitioner
- Paradise, CA
National Provider Identifier
1366658445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 15686
- Practice address
- 5125 Skyway
Paradise, CA 95969-5624 - Phone
- (530) 872-2000
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 15686 | CA | Primary |
Addresses
Primary practice location
5125 Skyway
Paradise, CA 95969-5624
Mailing address
5125 Skyway
Paradise, CA 95969-5624
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZR11629F | Medicaid | CA | |
| CMM70116G | Medicaid | CA | |
| CMM70268F | Medicaid | CA | |
| CMM70370F | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.77 of 100
- Quality
- 81.54
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15686 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Clearlake Hospital Inc. | Current | Accepting new patients | |
| Adventist Health Clearlake Hospital, Inc | Past | Accepting new patients | |
| Rideout Memorial Hospital | Past | Accepting new patients | |
| Michael R. Cosenza, DPM, Inc. | Past | Accepting new patients |
Locations
15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820
5125 Skyway
Paradise, CA 95969
Phone (530) 872-2000
Organizations & group practices 4
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.
-
- Critical Access Hospital
- Clearlake, CA
- NPI 1124018031
-
- Rural Health Clinic/Center
- Lakeport, CA
- NPI 1871063040
-
- Primary Podiatric Medicine Podiatrist
- Ukiah, CA
- NPI 1316459787
-
- General Acute Care Hospital
- Marysville, CA
- NPI 1720088354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1366658445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5125 SKYWAY",
"city": "PARADISE",
"state": "CA",
"postal_code": "959695624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5125 SKYWAY",
"city": "PARADISE",
"state": "CA",
"postal_code": "959695624",
"telephone_number": "530-872-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEHOE",
"first_name": "MOIRA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "15686",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZR11629F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CMM70116G",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CMM70268F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CMM70370F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paradise, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.