Thomas P. Moretti, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001037A Issued in IN

Practice address

500 Arcade Ave
Suite 400
Elkhart, IN 46514-2477

Phone

(574) 522-2284

Fax

(574) 522-3952

NPI assigned

Aug 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Locations

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.

• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment
• South Bend Emergency Physicians, Inc

  • Emergency Medicine Physician
  • South Bend, IN
  • NPI 1487132114
  Medicare reassignment
• Beacon Medical Group Inc

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  • Internal Medicine Physician
  • Elkhart, IN
  • NPI 1114262078
  NPD
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1124079330

  Physician Assistant

  NPD
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1588024624
  NPD
• Midwest Medical Group, LLC

  • Cardiovascular Disease Physician
  • Mishawaka, IN
  • NPI 1194734483
  NPD (past)

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1447406426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCADE AVE",
            "address_2": "SUITE 400",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142477",
            "telephone_number": "574-522-2284",
            "fax_number": "574-522-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETTI",
        "first_name": "THOMAS",
        "middle_name": "P.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-11",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001037A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01153860",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300008492",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG ORTHOPEDIC TRAUMA",
            "identifier": "000000634026",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger T Moore, M.D.
• Tatyana Moore
• Danielle Morales-Funez
• Alexia Morales
• Laarni May G Moreno, M.D.
• Sandra H. Morgan, M.D.
• Timothy E Morgan, MD
• Christina A Morris-Campbell
• Booker Talforia Morris, MD
• Eric Morris, MA

• Physician Assistant in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.