Individual provider Active NPI

Johnson Lee Moon, M.D.

  • Neurology Physician
  • Fullerton, CA
National Provider Identifier
1457407579
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A86444 Issued in CA
Practice address
381 E Imperial Highway
Fullerton, CA 92835
Phone
(714) 879-7200
Fax
(714) 879-3010
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A86444 CA Primary
Clinical Neurophysiology Physician 2084N0600X A86444 CA

Addresses

Primary practice location

381 E Imperial Highway
Fullerton, CA 92835

Mailing address

381 E Imperial Highway
Fullerton, CA 92835
Phone (714) 879-7200

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
I20080112000129 CA Practitioner - Neurology 3173604493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Iowa, RJ & L Carver College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Center of North Orange County a Medical CorpGroup PAC ID 4486617156, 5 clinicians

Practice addresses (Care Compare)

381 Imperial Hwy
Fullerton, CA 92835-1040
Phone (714) 879-7200

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

Merit-based Incentive Payment System (MIPS)

Final score
93.6 of 100Reported as group
Quality
95
Improvement activities
40
Cost
71.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86444CAMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Center of North Orange County, a Medical Corp. Neurology CurrentSince Aug 1, 2007 Accepting new patients
St Jude Hospital Inc PastSince Aug 1, 2007 Accepting new patients

Locations

381 Imperial Hwy
Fullerton, CA 92835
Phone (714) 879-7200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: johnsonmoon@nncoc.allscriptsdirect.net

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 6

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1457407579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 E IMPERIAL HIGHWAY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92835",
            "telephone_number": "714-879-7200",
            "fax_number": "714-879-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 E IMPERIAL HIGHWAY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92835",
            "telephone_number": "714-879-7200",
            "fax_number": "714-879-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JOHNSON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A86444",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A86444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.