NPIMap

Individual provider Active NPI

Leon A. Moak, PA-C

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1407878622
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2562 Issued in AZ
Practice address
475 S Dobson Rd
Chandler, AZ 85224-5605
Phone
(480) 963-4561
NPI assigned
Jul 24, 2006
Last updated
Oct 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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 2562 AZ Primary

Addresses

Primary practice location

475 S Dobson Rd
Chandler, AZ 85224-5605

Mailing address

3484 E Page Ave
Gilbert, AZ 85234-4239
Phone (602) 320-5944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001302 AZ Practitioner - Physician Assistant 5294723607 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Hyperbarics LLCGroup PAC ID 2264409697, 6 clinicians

Practice addresses (Care Compare)

1955 W Frye Rd
Chandler, AZ 85224-6282
Phone (480) 728-3974

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2562AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Critical Care Consultants LLC Current Accepting new patients
Team Physicians of Arizona PC Physician Assistant Past Accepting new patients

Organizations & group practices 5

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.

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1407878622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3484 E PAGE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852344239",
            "telephone_number": "602-320-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S DOBSON RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245605",
            "telephone_number": "480-963-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "LEON",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.