Individual provider Active NPI

Paul Moya, DO

  • Family Medicine Physician
  • Glendora, CA
National Provider Identifier
1396973699
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11804 Issued in CA
Practice address
210 S Grand Ave
Ste 415
Glendora, CA 91741-4292
Phone
(626) 335-3627
Fax
(626) 335-4806
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A11804 CA Primary

Addresses

Primary practice location

210 S Grand Ave
Ste 415
Glendora, CA 91741-4292

Mailing address

210 S Grand Ave
Ste 415
Glendora, CA 91741-4292
Phone (626) 335-3627

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101215000986 CA Practitioner - Family Practice 1557559648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Family Physicians IncGroup PAC ID 4082866025, 2 clinicians

Practice addresses (Care Compare)

210 S Grand Ave
Suite 415
Glendora, CA 91741-4292
Phone (626) 335-3627

Hospital & facility affiliations

  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
11804CAMDRegistered Nurse
20A11804CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Family Physicians, Inc. Family Medicine CurrentSince Dec 1, 2012 Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

210 S Grand Ave
Ste 415
Glendora, CA 91741
Phone (626) 335-3627

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: moyapaul@48489486.micromddirect.com

Organizations & group practices 2

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 1

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1396973699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "STE 415",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414292",
            "telephone_number": "626-335-3627",
            "fax_number": "626-335-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "STE 415",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414292",
            "telephone_number": "626-335-3627",
            "fax_number": "626-335-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.