Lisabeth D Hogan-Moody, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02623 Issued in TX

Practice address

2800 E Broad St
Suite 124
Mansfield, TX 76063-6409

Phone

(817) 539-0959

Fax

(817) 539-0480

NPI assigned

Mar 14, 2006

Last updated

Apr 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Mansfield Dermatology, PLLC

  • Dermatology Physician
  • Mansfield, TX
  • NPI 1598913253
  Medicare reassignment
• United Dermatology Associates of Euless PLLC

  dba Uda

  • Dermatology Physician
  • Euless, TX
  • NPI 1528829025
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1396714242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST",
            "address_2": "SUITE 124",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636409",
            "telephone_number": "817-539-0959",
            "fax_number": "817-539-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST",
            "address_2": "SUITE 124",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636409",
            "telephone_number": "817-539-0959",
            "fax_number": "817-539-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN-MOODY",
        "first_name": "LISABETH",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Hill, FNP
• Shavonne Hill, FNP
• April Hipp, OTR
• Margaret Hirsch, DDS
• Jeannine Koay Hoang, M.D.
• Angel Holbert
• Kirstie H Holbrook, M.ED., LPC
• Regenia K Holden, LCDC
• Anjae Taray Holder
• Holistic Approach to Mental Health, LLC

• Physician Assistant in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.