Individual provider Active NPI

Mark Raymond Moquin, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1386941904
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054787 Issued in PA
Practice address
205 S Front St
4TH Floor, Bma
Harrisburg, PA 17104-1619
Phone
(717) 231-8555
Fax
(717) 231-8568
NPI assigned
Feb 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054787 PA Primary

Addresses

Primary practice location

205 S Front St
4TH Floor, Bma
Harrisburg, PA 17104-1619

Mailing address

205 South Front Street
4TH Floor, Bma
Harrisburg, PA 17104-1619
Phone (717) 231-8555

Other identifiers 1

IdentifierTypeStateIssuer
103144704MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoquin7148@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110408000644 PA Practitioner - Physician Assistant 2961686365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Cardiovascular Institute IncGroup PAC ID 6901087006, 117 clinicians

Practice addresses (Care Compare)

111 S Front St
FL 2
Harrisburg, PA 17101-2010
Phone (717) 731-0101

360 Alexander Spring Rd
Carlisle, PA 17015-9129
Phone (717) 243-6557

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.6 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
71.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mmoquin297312@upmc.direct-ci.com

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 7

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": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1386941904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SOUTH FRONT STREET",
            "address_2": "4TH FLOOR, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "address_2": "4TH FLOOR, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOQUIN",
        "first_name": "MARK",
        "middle_name": "RAYMOND",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-16",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103144704",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoquin7148@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "205 S Front St",
            "address_2": "4th Floor, BMA",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171041619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.