Kristen L. Moore, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001138 Issued in CT

Practice address

John Dempsey Hospital
263 Farmington Avenue, MC-2948
Farmington, CT 06030-0001

Phone

(860) 679-4064

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmoore14514@middlesexhealthprd.direct-ci.com
• Direct secure messaging: kmoore10905@direct.med.uchc.edu

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.

• Connecticut Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882

  Physician Assistant

  Medicare reassignment NPD
• Middlesex Hospital Dba Family Practice Group Portland

  • Medical Physician Assistant
  • Portland, CT
  • NPI 1568597128
  NPD
• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1376609057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JOHN DEMPSEY HOSPITAL",
            "address_2": "263 FARMINGTON AVENUE, MC-2948",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JOHN DEMPSEY HOSPITAL",
            "address_2": "263 FARMINGTON AVENUE, MC-2948",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-2397",
            "fax_number": "860-679-1796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KRISTEN",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001138",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmoore8035@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Geoff Montgomery, NBCHWC
• Rachel Moody, MD
• Moon Poppy Psychotherapy LLC
• Arnold Nettleton Moore III, MD
• Iris Moore, DO
• Margaret Catherine Moore, LCSW
• Natalie Jeanne Moore, MD
• Thomas Moore, CRNA
• Tamar Mor
• Ana Paula Luzio Morais, M.D.

• Medical Physician Assistant in Farmington, CT
• Providers in Farmington, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.