Active NPI
Elizabeth Moe
- Pediatric Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1386363471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 340782
- Practice address
- 1919 E Thomas Rd
Phoenix, AZ 85016-7710 - Phone
- (602) 933-1000
- NPI assigned
- Aug 23, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RN193686 | AZ | |
| Pediatric Nurse Practitioner | 363LP0200X | 340782 | AZ | Primary |
Addresses
Primary practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Mailing address
2108 E Thomas Rd
Phoenix, AZ 85016-7761
Phone (602) 933-3124
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN193586 | Medicaid | AZ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Pch |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN193686 | AZ | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781568000000",
"number": "1386363471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167761",
"telephone_number": "602-933-3124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "602-933-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOE",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-23",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "AZ",
"license": "RN193686",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AZ",
"license": "340782",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RN193586",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pch",
"affiliation": "N",
"address_1": "1919 E Thomas Rd",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850167710",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.