Individual provider Active NPI

Hawnwan Philip Moy, MD

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1407017569
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2011024862 Issued in MO
Practice address
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone
(314) 525-1906
NPI assigned
Jun 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2011024862 MO Primary

Addresses

Primary practice location

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Mailing address

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

Other practice location 1

1000 E Cherry St
Troy, MO 63379-1513
Phone (636) 528-8551

Other identifiers 1

IdentifierTypeStateIssuer
207117201MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20120125000298 MO Practitioner - Emergency MedicinePractitioner - General Practice 3072780493 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital SouthGroup PAC ID 8426962556, 45 clinicians
Mercy Hospitals East CommunitiesGroup PAC ID 1658276811, 92 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (636) 251-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011024862MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital South CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital Lincoln CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 1, 2022 Accepting new patients
University of North Carolina at Chapel Hill Emergency Medicine Past Accepting new patients

Locations

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Interoperability endpoints

  • Direct secure messaging: hmoy154522@direct.carenet.org

Organizations & group practices 10

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 3

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": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1407017569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Cherry St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MO",
            "postal_code": "633791513",
            "country_code": "US",
            "telephone_number": "636-528-8551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOY",
        "first_name": "HAWNWAN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-21",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2011024862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207117201",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "400 S Kingshighway Blvd",
            "address_2": "Dept Emergency Medicine",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.